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| {{Tuberculosis}} | | __NOTOC__ |
| | {{HIV coinfection with tuberculosis}} |
| '''For main chapter on AIDS, click [[AIDS|here]]''' | | '''For main chapter on AIDS, click [[AIDS|here]]''' |
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| '''For main chapter on HIV, click [[HIV|here]]''' | | '''For main chapter on HIV, click [[HIV|here]]''' |
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| {{CMG}}; {{AOEIC}} [[User:Ujjwal Rastogi|Ujjwal Rastogi, MBBS]] [mailto:urastogi@perfuse.org]
| | '''For main chapter on Tuberculosis, click [[Tuberculosis|here]]''' |
| ==Overview==
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| HIV is the main reason for failure to meet Tuberculosis (TB) control targets in high HIV settings. In spite of fewer people in USA suffering with TB, it remains a serious threat, especially for HIV-infected persons. In fact, worldwide TB is one of the leading causes of death among people infected with HIV. It is estimated that about 4.2% of Americans, with or without HIV infection, are infected with TB bacteria. People infected with HIV are more likely than uninfected people to get sick with other infections and diseases.
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| ==Pathophysiology: The connection between TB and HIV==
| | '''For patient information, click [[HIV coinfection with tuberculosis (patient information)|here]]''' |
| 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.
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| 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.
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| ==Epidemiology & Demographics== | | ==[[HIV coinfection with tuberculosis overview|Overview]]== |
| *Approximately 1.1 million persons were living with HIV infection at the end of 2006. As many as 21% of infected persons are unaware of their infection.
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| *It is estimated that about 4.2% of Americans with or without HIV infection are infected with the TB bacteria. In 2009 there were approximately 13 million Americans with latent TB infection (LTBI).
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| *In 2009, among persons with TB who had a documented HIV test result, more than 10% (690 of 6,743) were co-infected with HIV.
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| *In 2006, the HIV status of 1 in 5 patients with TB was not known, even though CDC recommends that all persons with TB be tested for HIV.
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| *In 2006, nearly 20% of patients with TB and HIV died. Persons with HIV and TB accounted for 32% of those who died during TB treatment and 51% of those who received a TB diagnosis after death.
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| *In 2005, of the TB patients reported to be co-infected with HIV, 63% were non-Hispanic blacks.
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| ==Risk Factors== | | ==[[HIV coinfection with tuberculosis pathophysiology|Pathophysiology]]== |
| The risk of developing tuberculosis (TB) is estimated to be between 20-37 times greater in people living with HIV than among those without HIV infection. In 2009, there were 9.4 million new cases of TB, of which 1.2 (13%) million were among people living with HIV. Of the 1.7 million people who died of TB, 400 000 (24%) were living with HIV. TB is a leading cause of morbidity and mortality among people living with HIV.
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| | ==[[HIV coinfection with tuberculosis causes|Causes]]== |
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| | ==[[HIV coinfection with tuberculosis differential diagnosis|Differentiating HIV coinfection with tuberculosis from other Diseases]]== |
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| | ==[[HIV coinfection with tuberculosis epidemiology and demographics|Epidemiology and Demographics]]== |
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| | ==[[HIV coinfection with tuberculosis risk factors|Risk Factors]]== |
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| | ==[[HIV coinfection with tuberculosis screening|Screening]]== |
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| | ==[[HIV coinfection with tuberculosis natural history, complications and prognosis|Natural History, Complications and Prognosis]]== |
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| ==Diagnosis== | | ==Diagnosis== |
| A new rapid diagnostic test for TB disease, the Xpert MTB/RIF assay (which is not currently approved by the US Food and Drug Administration for use in the US), is expected to reduce patient and health service diagnostic delays, decentralize the diagnosis of MDR TB and HIV-associated TB, and accelerate patient access to appropriate care. Evidence suggests that use of the test might double the number of HIV-associated TB cases diagnosed in areas with high rates of TB and HIV.
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| | [[HIV coinfection with tuberculosis history and symptoms|History and Symptoms]] | [[HIV coinfection with tuberculosis physical examination|Physical Examination]] | [[HIV coinfection with tuberculosis laboratory findings|Laboratory Findings]] | [[HIV coinfection with tuberculosis other diagnostic studies|Other Diagnostic Studies]] |
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| ==Treatment== | | ==Treatment== |
| Recommendations for treating tuberculosis in adults with HIV infection are, with a few exceptions, the same as those for adult TB patients who are not HIV infected. However, managing HIV-related TB is complex and people with HIV and TB should seek care from a health care provider or providers with expertise in the management of both HIV disease and TB. Because persons with HIV infection are often taking numerous medications, some of which interact with anti-TB medications, experts in the treatment of HIV-related TB should be consulted.
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| ==Prevention==
| | [[HIV coinfection with tuberculosis medical therapy|Medical Therapy]] | [[HIV coinfection with tuberculosis prevention|Prevention]] |
| A new epidemiological model, developed by WHO, UNAIDS and the Stop TB Partnership, shows it is possible to reduce HIV/AIDS deaths impressively through tuberculosis (TB) prevention and treatment. In 2009 almost one in four deaths among people living with HIV were due to TB, a disease that is both curable and preventable. The model estimates that through the scaled-up implementation of WHO-recommended collaborative TB/HIV activities, it is possible to save a million lives by the end of 2015.
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| A publication 'Time to act: Save a million lives by 2015 – Prevent and treat tuberculosis among people living with HIV' was launched on June 6, 2011 at the UN headquarters in New York.
| | ==Case Studies== |
| | [[HIV coinfection with tuberculosis case study one|Case #1]] |
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| == Reference == | | ==Related Chapters== |
| {{reflist|2}}
| | * [[Coinfection]] |
| | * [[AIDS]] |
| | * [[HIV disease]] |
| | * [[Hepatitis C with HIV coinfection]] |
| | * [[Hepatitis B with HIV coinfection]] |
| | * [[Immune reconstitution inflammatory syndrome ]] |
| | * [[Tuberculosis]] |
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| {{WH}} | | {{WH}} |
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| [[Category:Disease]] | | [[Category:Disease]] |
| [[Category:Pulmonology]] | | [[Category:Pulmonology]] |
| [[Category:Infectious disease]]
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