Tuberculosis and HIV Coinfection
- 1Unit of Infectious Diseases, Institution of Medicine Solna, Karolinska Institutet and Karolinska University Hospital, Stockholm SE-171 77, Sweden
- 2Life and Health Sciences Research Institute (ICVS), School of Health Sciences, University of Minho, Braga 4710-057, Portugal
- 3ICVS/3B’s, PT Government Associate Laboratory, Braga/Guimarães 4710-057, Portugal
- 4Karolinska Institutet, Department of Clinical Science and Education, Stockholm SE-118 83, Sweden
- Correspondence: gunilla.kallenius{at}ki.se
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↵5 These authors contributed equally to this work.
Abstract
Tuberculosis (TB) and human immunodeficiency virus/acquired immunodeficiency syndrome (HIV/AIDS) constitute the main burden of infectious disease in resource-limited countries. In the individual host, the two pathogens, Mycobacterium tuberculosis and HIV, potentiate one another, accelerating the deterioration of immunological functions. In high-burden settings, HIV coinfection is the most important risk factor for developing active TB, which increases the susceptibility to primary infection or reinfection and also the risk of TB reactivation for patients with latent TB. M. tuberculosis infection also has a negative impact on the immune response to HIV, accelerating the progression from HIV infection to AIDS. The clinical management of HIV-associated TB includes the integration of effective anti-TB treatment, use of concurrent antiretroviral therapy (ART), prevention of HIV-related comorbidities, management of drug cytotoxicity, and prevention/treatment of immune reconstitution inflammatory syndrome (IRIS).
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