HIV cohorts
| First author, year | Country | Years of study | Study description | Number of TB cases | Number in cohort | Patient-years | TB incidence, per cent per year (95% CI) | ART at enrolment (%) | Number male | Age range | Quality, TB incidence (selection/outcomes)* | Quality, immunosuppression (selection/comparability/outcomes)* | Quality, CD4% (selection/comparability/outcomes)* | Quality, time-on-ART (selection/comparability/outcomes)* | Quality, ART protection (selection/comparability/outcomes)* |
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| Abuogi, 201360 | Kenya | 2009–2010 | Prospective cohort study of HIV-infected children (6 weeks to 14 years, some on ART and some not) followed-up for the incidence of clinically diagnosed TB. Study at two urban clinics with children recruited over a 2-year period | 10 | 686 | 720 | 1.39 (0.75 to 2.58) | 74 | 322 | 0–14 | B/A | B/C/A | na | na | na |
| Alarcón, 201261 | Brazil | 2002–2007 | Prospective cohort study of HIV-infected children (<21 years) at 17 sites in Latin America; children recruited over a 5-year period and followed for the incidence of a number of opportunistic infections, including TB | 7 | 731 | 2523 | 0.28 (0.07 to 0.48) | 67 | 325 | 0–22 | B/B | na | na | na | na |
| Auld, 201462 | Côte d'Ivoire | 2004–2008 | A nationally representative retrospective cohort study of children (<15 years) starting ART over a 5-year period at 29 facilities | 56 | 1960 | 4190 | 1.34 (1.03 to 1.74) | 100 | 1058 | 0–14 | C/C | na | C/A/C | B/C/C | na |
| Bakeera-Kitaka, 201163 | Uganda | 2003–2006 | Retrospective cohort study of children and adolescents starting ART over a 3½-year period at one specialist clinic | 311 | 1806 | 1690 | 18.4 (17.1 to 20.3) | 100 | 932 | ns | C/C | na | na | B/C/C | B/A/C |
| Braitstein, 200964 | Kenya | 2001–2007 | Retrospective observational study of all children (<13 years) enrolled in a network of HIV clinics over a 5-year period | 765 | 6301 | 4368 | 17.6 (16.3 to 18.8) | 19 | 3144 | 0–13 | C/C | na | na | B/C/C | B/A/C |
| Brennan, 201465 | South Africa | 2004–2011 | Retrospective cohort of all children (<19 years) on ART enrolled over a 7-year period at 12 urban clinics | 113 | 3329 | 2828 | 4.0 (3.3 to 4.8) | 100 | 1608 | 0–18 | C/C | na | C/A/C | B/A/C | na |
| Ciaranello, 201466 | East Africa | 2002–2008 | All HIV-infected infants (<12 months) enrolled over a 6-year period at 7 sites across 3 countries | 128 | 847 | 738 | 17.4 (14.5 to 20.6) | 0 | 418 | <1 | C/C | na | C/C/C | na | na |
| Crook, 201614 | Uganda, Zimbabwe | 2007–2012 | Randomised controlled trial assessing different monitoring strategies for providing ART. All HIV-infected children (3 months to 17 years) enrolled from 4 centres in 2 countries over an 18-month period | 69 | 969 | 3632 | 1.9 (1.5 to 2.4) | 100 | 488 | 0–17 | B/B | na | B/A/B | A/C/B | na |
| Curtis, 201267 | Eight countries | 2002–2010 | Data from 25 HIV treatment centres in 8 countries collected prospectively over an 8-year period. Adults and children included if starting ART at one of the centres. Data from children (<15 years) disaggregated from adults | 140 | 3946 | 1687 | 8.3 (8.1 to 8.6) | 100 | ns | 0–15 | C/C | na | na | B/C/C | na |
| Dankne, 200168 | USA | 1988–1998 | Data from 13 studies over a period of 10 years with children (<21 years) included. From pre-ART period. Wide range of opportunistic infections assessed | 27 | 3331 | 6750 | 0.4 (0.3 to 0.6) | 0 | 1852 | 0–21 | C/C | na | C/C/C | na | na |
| De Beaudrap, 201369 | Burkina Faso/Côte d'Ivoire | 2006–2007/2000–2004 | Pooled data from a clinical trial (recruited over 1 year) and observational cohort (recruited over 4 years). Children (15 months to 15 years) enrolled at initiation of ART and followed for 2 years | 10 | 188 | 355 | 2.9 (1.4 to 5.1) | 100 | 66 | ns | C/A | na | C/C/A | B/C/A | na |
| Edmonds, 200970 | Democratic Republic of Congo | 2004–2008 | Prospective study of children (<18 years) enrolled from one hospital clinic over a 3½-year period. All children ART-naïve at baseline with some starting ART during follow-up | 81 | 364 | 596 | 13.6 (10.8 to 16.9) | 0 | 172 | 0–18 | B/B | B/C/B | na | A/C/B | A/A/B |
| Gray, 201471 | South Africa | 2005–2011 | Control (placebo) arm of a randomised controlled trial of isoniazid preventive therapy. Children (over 8 weeks) recruited over a 4-year period from three sites | 7 | 82 | 240 | 2.9 (1.2 to 6.0) | 100 | 42 | ns | A/B | na | na | na | na |
| Kouakoussui, 200472 | Côte d'Ivoire | 2000–2003 | All children recruited from one clinic and followed-up for incident TB. All children in the study initiated ART at some point in the study to provide pre-ART and post-ART TB incidences | 7 | 282 | 206 | 3.4 (1.5 to 6.7) | 65 | 153 | 1–16 | C/B | na | C/C/C | na | na |
| Li, 201373 | Tanzania | 2004–2011 | Prospective study of all children (<15 years) from 28 clinics recruited over a 7-year period. ART started based on local guidelines over follow-up | 376 | 5040 | 7221 | 5.2 (4.7 to 5.8) | 51 | 2460 | 0–14 | B/C | B/A/C | na | A/A/C | A/A/C |
| Martinson, 200974 | South Africa | 1994–2006 | Retrospective cohort of children (<15 years) recruited from four clinics over a 12-year period. Incidence determined for the period pre-ART and post-ART | 281 | 1132 | 1713 | 12.3 (9.8 to 12.6) | 2 | 563 | 0–14 | B/C | na | na | na | A/A/C |
| Prasitsuebsai, 201475 | SE Asia | 1993–2009 | Retrospective and prospective cohort of HIV-infected children (≤18 years) from 14 clinics in 5 countries in SE Asia. Recruited over a 16-year period. Wide range of OIs assessed. Period covered before ART, during monotherapy or dual-therapy and on HAART | 477 | 2280 | 1826 | 21.5 (19.4 to 23.7) | 7 | 1136 | 0–18 | C/C | na | na | na | na |
| Thomas, 200076 | USA (New York City) | 1989–1995 | Retrospective study in HIV-exposed and HIV-infected children enrolled in a longitudinal study. TB cases determined by review of clinical records and by linkage to local TB registry. Registry data assessed for a 6-year period | 45 | 1426 | 7384 | 0.61 (0.44 to 0.82) | 0 | 475 | 0–12 | B/B | na | na | na | na |
| Walters, 200877 | South Africa | 2003–2005 | Chart review of all children (<13 years) starting HAART at one hospital over a 3-year period and followed-up until the end of the study period for incident TB. Cases defined as pre-HAART (if in the 9 months prior to HAART initiation) or post-HAART | 10 | 290 | 546 | 25.1 (21.1 to 29.6) | 0 | 142 | 0–14 | C/A | na | na | na | na |
| Walters, 201478 | South Africa | 2003–2010 | Retrospective cohort of all children (<2 years) starting HAART at one hospital over an 8-year period. Children divided into those developing TB-IRIS (developing TB with 3 months of starting HAART) and those with incident TB (developing TB after 3 months) | 55 | 341 | 855 | 25.3 (22.0 to 28.9) | 0 | 161 | <2 | B/C | na | na | A/C/C | na |
| Yirdaw, 201479 | Ethiopia | 2007–2010 | Retrospective cohort study of the electronic records of all patients (adults and children) starting ART over a 3-year period in five hospitals in one region of Ethiopia. Patients followed until the end of the study period and the interventions of ART and IPT evaluated. Incidence stratified by age enabling extraction children (<15 years) | 23 | 475 | 1099 | 2.1 (1.3 to 3.1) | ns | ns | 0–15 | B/C | na | na | na | A/C/C |
| Zar, 200780 | South Africa | 2003–2004 | Double-blind randomised controlled trial evaluating the impact of IPT on TB incidence in HIV-infected children (aged older than 8 weeks). Children recruited from two sites with the trial stopped after 17 months. Data on TB incidence taken from placebo arm | 13 | 131 | 56 | 23.4 (12.4 to 50.0) | 8 | 74 | 0–14 | C/C | na | na | na | na |
*Adapted Newcastle-Ottawa tool for cohort studies: A=high quality; B=moderate quality; C=low quality; see online supplementary material pp. 19–21, 26–27.
ART, antiretroviral therapy; HAART, highly-active antiretroviral therapy; IPT, isoniazid preventive therapy; IRIS, immune reconstitution inflammatory syndrome; OIs, opportunistic infections; na, not applicable; ns, not stated.