Abstract
AN OVERVIEW OF HIV- TB COINFECTION

Harikrishna Eppa*

ABSTRACT

Tuberculosis (TB) and the human immunodeficiency virus (HIV) are, individually, two of the world's greatest ongoing public health threats. In combination, the two diseases can be even more devastating. Several aspects of human immunodeficiency virus (HIV) infection-related tuberculosis (TB) and its treatment differ from those of TB in HIV-uninfected persons. The human immunodeficiency virus (HIV) pandemic has amplified the global burden of tuberculosis (TB), particularly in sub-Saharan Africa, where 82% of the world's TB/HIV coinfection exists. HIV infection significantly increases the risk of developing and dying from TB and was associated with 350,000 TB deaths in 2010. Antiretroviral therapy has a profound effect on lowering the risk of TB in HIV-infected persons, but it can also be associated with immune reconstitution inflammatory disease and unmasking of previously subclinical disease. The comanagement of HIV and TB is challenging due to drug-drug interactions, overlapping drug toxicities, concerns about adherence, and the immune reconstitution inflammatory syndrome. However, the initiation of antiretroviral therapy (ART) during the course of TB treatment is necessary to improve survival, and the appropriate timing of ART is dependent on the level of immune suppression. Therefore, the management of TB must be well coordinated with HIV resources, prepared to rapidly diagnose HIV, assess immune status, and correctly treat both infections. In addition a much stronger focus on prevention needs to include concerted action with regard to HIV/AIDS prevention and addressing social determinants of disease such as poverty, malnutrition and overcrowding.

Keywords: HIV/AIDS, Tuberculosis, Epidemiology, Clinical manifestations, Diagnosis Mortality, Treatment.


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