HIV/TB Co-Infection

In HIV infected patients, tuberculosis is the leading cause of death through the world. According to some World Health Organization (WHO) reports, the risk of tuberculosis disease in People Living with HIV (PLHIV) is about 10-20 times greater than people without HIV. The risk of developing tuberculosis disease in PPD positive HIV infected is about 10% annually but in HIV un-infected people is about 10% throughout their life. HIV accelerates the progression of tuberculosis infection toward disease both in recent and latent infection of TB. Pulmonary tuberculosis is the most common type of TB and its symptoms are related to the immune status of the patients and the level of progression to AIDS. Usually, signs and symptoms of tuberculosis are mild and it is difficult to diagnose. In smear negative pulmonary TB which is mostly observed in advanced HIV infection, mortality and morbidity would be higher due to the delay in establishing the diagnosis. Considering that reactivation of Latent TB (LTB) to active tuberculosis is more prevalent in PLHIV compared to HIV negative people, the diagnosis of LTB infection would be an important priority and screenings for TB should be done periodically among PLHIV as a priority. Any PLHIV with suspected LTB is eligible for isoniazid (INH) prophylaxis. All PLHIV with tuberculosis disease should be under Antiretroviral Therapy (ART) irrespective of CD4 cell count.

Keywords: AFB, AIDS, ART, CD4 cell, LTB, PLHIV, Prophylaxis, PPD, Tuberculosis, XDR-TB.