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. HIV significantly increases an individual's chances
of reactivation of latent TB infection and progression to active TB disease. HIV's
associated immunosuppression makes it more difficult to diagnose active TB due to
a higher likelihood of atypical and extrapulmonary presentation and poorer performance
of standard diagnostic tools. TB is the major cause of death in individuals infected
with HIV, and the combination of both illnesses creates unique treatment challenges
for providers due to interactions between antituberculous and antiretroviral medications,
overlapping drug toxicities, and the immune reconstitution inflammatory syndrome.
Magnifying these challenges even further is the fact that much of the burden of TB/HIV
coinfection exists in some of the world's most resource-limited settings. Concerted
efforts are needed to identify rapid and accurate diagnostic tools for active TB disease
and latent TB infection (LTBI) that are practical and inexpensive and that perform
well in individuals with HIV infection. Also needed are effective and feasible strategies
to optimize management of both conditions in the coinfected patient.
KEYWORDS
Tuberculosis - human immunodeficiency virus - diagnosis - treatment
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Simon J TsiourisM.D. M.P.H.
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622 West 168th St., PH 8 – 876W, New York, NY 10032
Email: st326@columbia.edu
