HIV Infection–Associated Tuberculosis: The Epidemiology and the Response

Abstract

Of the 33.2 million persons infected with human immunodeficiency virus (HIV), one-third are estimated to also be infected with Mycobacterium tuberculosis. In 2008, there were an estimated 1.4 million new cases of tuberculosis (TB) among persons with HIV infection, and TB accounted for 26% of AIDS-related deaths. The relative risk of TB among HIV-infected persons, compared with that among HIV-uninfected persons, ranges from 20- and 37-fold, depending on the state of the HIV epidemic. In 2008, 1.4 million patients with TB were tested globally for HIV, and 81 countries tested more than half of their patients with TB for HIV. Only 4% of all persons infected with HIV were screened for TB in the same year. Decentralization of HIV treatment services and strengthening of its integration with TB services are essential. Use of the highly decentralized TB services as an entry point to rapidly expand access to antiretroviral therapy and methods for prevention of HIV infection must be pursued aggressively.

HIV–TB coinfection impairs CD8+ T‐cell differentiation and function while dehydroepiandrosterone improves cytotoxic antitubercular immune responses

“…2015. 45: 2529-2541 from latent to active TB disease, increasing the risk of latent TB (LTB) reactivation up to 20-fold [1]. It is well established that CD4 + T cells are critical for resistance to Mtb [2].…”

“…HIV coinfection is the main risk factor for progression from latent to active TB disease, increasing the risk of latent TB (LTB) reactivation up to 20-fold [1].…”

HIV Co-Infection with Hepatotropic Viruses and Mycobacterial Tuberculosis

“…In Europe and North America there has also been a rise in TB cases since mid-1980s [51]. The recent resurgence of TB with HIV pandemic remains a major public health dilemma with TB as the leading cause of death among persons with HIV/AIDS despite the use of highly active antiretroviral therapy (HAART) [52]. In 1993, World Health Organization (WHO) declared TB as a global emergency because of the rising cases of deaths and infection rates [53].…”

Acute Phase Proteins and Stress Hormone Responses in Patients with Newly Diagnosed Active Pulmonary Tuberculosis

“…[4] The human immunodeficiency virus (HIV) pandemic, affecting both the developing and developed countries, is one of the reasons for the enormous increase in TB infections worldwide, with the brunt of these co-infections occurring in developing countries, such that HIV/TB co-infection prevalence rates exceed 5% in some African countries. [1,2,5] South Africa is estimated to have the highest incidence rates and the highest prevalence of TB, the second highest number of cases of multi-drug resistant TB and also the highest number of TB-HIV co-infected cases. [6] In response to an infection, such as TB, the human host mounts an acute phase response, which encompasses a diverse range of systemic effects that accompany inflammation.…”