HIV coinfection with tuberculosis
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HIV coinfection with tuberculosis On the Web |
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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor(s)-In-Chief: Ujjwal Rastogi, MBBS [2]
Overview
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.
Pathophysiology: The connection between TB and HIV
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.
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.
Epidemiology & Demographics
- 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.
- 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).
- 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.
- In 2005, of the TB patients reported to be co-infected with HIV, 63% were non-Hispanic blacks.
- 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.
- 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.
Risk Factors
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.