Tuberculosis and HIV/AIDS: epidemiological and clinical aspects (world perspective)

Area of Science:

• Global Health
• Infectious Diseases
• Public Health

Background:

• Human immunodeficiency virus (HIV) infection is a primary driver for the progression of latent Mycobacterium tuberculosis infection to active tuberculosis (TB) disease.
• The global HIV epidemic profoundly impacts TB, affecting its immunopathology, epidemiology, diagnosis, treatment, and prevention strategies.
• Over a quarter of the 42 million people living with HIV globally are also infected with TB, predominantly in resource-limited regions of Africa and Asia.

Purpose of the Study:

• This chapter focuses on the challenges and implications of HIV-associated TB within resource-limited settings.
• To highlight the increased rate of TB disease progression in HIV-infected individuals.
• To underscore the diagnostic and therapeutic complexities of co-infected patients.

Main Methods:

• Review of current literature and epidemiological data on HIV and TB co-infection.
• Analysis of diagnostic tool performance in HIV-TB co-infected populations.
• Examination of treatment regimens, drug interactions, and immune reconstitution inflammatory syndrome (IRIS) in HIV-TB patients.

Main Results:

• HIV-associated immunosuppression accelerates TB progression, with rates up to 10% annually.
• Standard TB diagnostic tools exhibit reduced sensitivity in HIV co-infected individuals.
• Treatment efficacy is compromised by factors including drug toxicity, malabsorption, drug interactions, and paradoxical reactions.

Conclusions:

• The dual burden of HIV and TB poses a significant threat to public health infrastructure, particularly in resource-limited countries.
• Effective TB control requires substantial political will and resource allocation, as demonstrated by past challenges in the United States.
• An intensified international response is crucial to address the escalating crisis of HIV-associated TB globally.