HIV coinfection with tuberculosis pathophysiology: Difference between revisions

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==Overview==
==Overview==
People infected with HIV (the virus that causes AIDS) are more likely than uninfected people to get sick with other infections and diseases. Tuberculosis (TB) is one of these diseases. TB is a disease that usually affects the lungs. It sometimes affects other parts of the body, such as the brain, the kidneys, or the spine.
The likelihood of getting [[Illness|sick]] with other [[Infection|infections]] and [[Disease|diseases]] is much more in [[Human Immunodeficiency Virus (HIV)|HIV]]-infected individuals. [[Tuberculosis]] ([[Tuberculosis|TB]]) is one of these [[Disease|diseases]]. [[Tuberculosis|TB]] commonly affects the [[Lung|lungs]]; however, It can sometimes affects other [[Organ (anatomy)|organs]] and body parts, such as the [[brain]], [[heart]], [[Kidney|kidneys]], or [[spine]].


==Pathophysiology==
==Pathophysiology==
HIV infection weakens the immune system. If a person’s immune system gets weak, TB infection can activate and become TB disease. Someone with TB infection and HIV infection has a very high risk of developing TB disease. Without treatment, these two infections can work together, to shorten the life of the person infected with both.
 
* [[HIV AIDS|HIV infection]] weakens the [[immune system]] allowing [[TB infection]] to activate and turn into active [[Tuberculosis|TB]] disease. Individuals with both [[Tuberculosis|TB]] infection and [[Human Immunodeficiency Virus (HIV)|HIV]] infection has a very high risk of developing active [[Tuberculosis|TB]] disease. Without [[treatment]], these two [[Infection|infections]] can work together, to shorten the life span of the person infected with both.
 
* In patients with advanced [[Human Immunodeficiency Virus (HIV)|HIV]] disease, there is no sufficient [[Cell-mediated immunity|cell-mediated immune]] response to create [[cavitation]] and usually presents with [[Lobar pneumonia|lobar]], [[Pleural cavity|pleural]] or disseminated disease.
* TB pleural effusion is [[Exudate|exudative]], [[lymphocyte]]-predominant, and contains high [[adenosine deaminase]] levels.
* [[Tuberculosis|TB]] [[pleural effusion]] occurs as a result of [[Hypersensitivity|hypersensitivity reaction]] to [[Mycobacterium tuberculosis|M.tuberculosis]], so [[Pleural effusion|pleural fluid]] [[Smear test|smear]] is often negative for [[Acid fast bacilli|acid-fast bacilli]] and [[pleural]] [[biopsy]] is the gold standard for confirming the [[diagnosis]].
* Treatment of [[Human Immunodeficiency Virus (HIV)|HIV]] has to be delayed 1-2 weeks after [[Tuberculosis|TB]] treatment to avoid [[immune reconstitution inflammatory syndrome]] ([[IRIS]]).


===Do all people with HIV get TB disease?===
===Do all people with HIV get TB disease?===
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===What is the difference between latent TB infection and active TB disease?===
===What is the difference between latent TB infection and active TB disease?===


TB is spread through the air from one person to another. The bacteria are put into the air when a person with TB disease of the lungs or throat coughs or sneezes. People nearby may breathe in these bacteria and become infected. However, not everyone infected with TB bacteria becomes sick. As a result, two TB-related conditions exist: latent TB infection and active TB disease.
[[Tuberculosis|TB]] is spread through the air from one person to another. The [[Infection|infectious]] [[droplets]] containing the [[Mycobacterium|mycobacteria]] are expelled into the [[air]] when a patient with [[Tuberculosis|TB]] disease of the [[Lung|lungs]] or throat [[Cough|coughs]] or [[Sneeze|sneezes]]. Individuals nearby may get exposed and [[Inhalation|inhale]] these [[Mycobacterium|mycobacteria]] and therefore they get [[Infection (disambiguation)|infected]]. However, not everyone gets exposed and infected with [[Tuberculosis|TB]] [[Mycobacterium|mycobacteria]] becomes [[sick]]. As a result, two [[Tuberculosis|TB]]-related conditions exist: latent [[Tuberculosis|TB]] infection and [[Active Living|active]] TB disease.


In most people who breathe in TB bacteria and become infected, the body is able to fight the bacteria and stop them from growing. The bacteria become inactive, but they remain alive in the body and can become active later. This is called latent TB infection. However, TB bacteria can become active if the immune system can’t stop them from growing. These bacteria begin to multiply in the body and cause active TB disease.
Most people who get exposed to [[Tuberculosis|TB]] [[Mycobacterium tuberculosis|mycobacteria]] and become infected are able to control the bacteria and stop them from growing. Consequently, the bacteria become inactive, but they remain [[dormant]] and alive in the [[Human body|body]] and can get activated later if the [[immune system]] is impaired and cannot control the growing of the [[Mycobacterium|mycobacterial]] infection. This is called latent [[Tuberculosis|TB]] [[infection]]. With impaired [[immune system]], these [[Mycobacteria tuberculosis|mycobacteria]] begin to multiply in the [[Human body|body]] and cause active TB disease.


There are an estimated 9 to 14 million persons in the United States infected with TB bacteria. Most people who have latent TB infection never develop active TB disease. In these people, the TB bacteria remain inactive for a lifetime without causing disease. A person with latent TB infection does not feel sick and cannot spread TB bacteria to others. Because HIV weakens the immune system, people with latent TB infection and HIV infection are at very high risk of developing active TB disease. These bacteria begin to multiply in the body and cause active TB disease.
There are an estimated 9 to 14 million persons in the United States infected with [[Tuberculosis|TB]] bacteria. However, it has been reported that most people who have latent [[Tuberculosis|TB]] [[infection]] never develop active [[Tuberculosis|TB]] [[disease]]. In these people, the TB bacteria remain inactive for a lifetime without causing [[disease]]. Individuals with latent [[Tuberculosis|TB]] [[infection]] do not feel [[Illness|sick]] or spread TB mycobacteria to others. Since [[Human Immunodeficiency Virus (HIV)|HIV]] affects the [[immune system]], people with [[latent TB]] infection and [[Human Immunodeficiency Virus (HIV)|HIV]] [[coinfection]] are at much higher risk of developing active [[Tuberculosis|TB]] disease. These [[Mycobacterium|mycobacteria]] begin to [[multiply]] in the body and cause [[active TB disease]].


==References==
==References==

Latest revision as of 05:11, 6 April 2021

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Overview

The likelihood of getting sick with other infections and diseases is much more in HIV-infected individuals. Tuberculosis (TB) is one of these diseases. TB commonly affects the lungs; however, It can sometimes affects other organs and body parts, such as the brain, heart, kidneys, or spine.

Pathophysiology

  • HIV infection weakens the immune system allowing TB infection to activate and turn into active TB disease. Individuals with both TB infection and HIV infection has a very high risk of developing active TB disease. Without treatment, these two infections can work together, to shorten the life span of the person infected with both.

Do all people with HIV get TB disease?

No, but it does increases the chance of getting TB disease if patient have both TB infection and HIV infection. For this reason, if patient have HIV infection, the doctor must also get a TB skin test.

What is the difference between latent TB infection and active TB disease?

TB is spread through the air from one person to another. The infectious droplets containing the mycobacteria are expelled into the air when a patient with TB disease of the lungs or throat coughs or sneezes. Individuals nearby may get exposed and inhale these mycobacteria and therefore they get infected. However, not everyone gets exposed and infected with TB mycobacteria becomes sick. As a result, two TB-related conditions exist: latent TB infection and active TB disease.

Most people who get exposed to TB mycobacteria and become infected are able to control the bacteria and stop them from growing. Consequently, the bacteria become inactive, but they remain dormant and alive in the body and can get activated later if the immune system is impaired and cannot control the growing of the mycobacterial infection. This is called latent TB infection. With impaired immune system, these mycobacteria begin to multiply in the body and cause active TB disease.

There are an estimated 9 to 14 million persons in the United States infected with TB bacteria. However, it has been reported that most people who have latent TB infection never develop active TB disease. In these people, the TB bacteria remain inactive for a lifetime without causing disease. Individuals with latent TB infection do not feel sick or spread TB mycobacteria to others. Since HIV affects the immune system, people with latent TB infection and HIV coinfection are at much higher risk of developing active TB disease. These mycobacteria begin to multiply in the body and cause active TB disease.

References

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