The risk and prognosis of tuberculosis (TB) are affected by both human and bacterial genetic factors. To identify interacting human and bacterial genetic loci, we leveraged paired human andMycobacterium tuberculosis(M.tb) genomic data from 1000 Tanzanian TB patients. Through a genome-to-genome approach, we identified two pairs of human andM.tbgenetic variants that are significantly associated. One of the human genetic variants maps to the intron ofPRDM15, a gene involved in apoptosis regulation. The other human variant maps to an intergenic region close toTIMM21andFBXO15. In addition, we observed that a group of linkedM.tbepitope variants were significantly associated with HLA-DRB1 variation. This suggests that even though epitope variation is rare inM.tbin general, specific epitopes might still be under immune selective pressure. Overall, our study pinpoints sites of genomic conflicts between humans andM.tb, suggesting bacterial escape from host selection pressure.