Prevention of tuberculosis in people living with HIV

Human immunodeficiency virus (HIV) infection drives tuberculosis (TB) incidence, and in some African countries, 80% of persons with TB have HIV infection. By the end of 2008, an estimated 33.2 million persons were infected with HIV, and in 2007, there were 2.7 million new HIV infections and 2 million HIV infection-related deaths. During the same year, there were 1.37 million (15%) cases of TB and HIV coinfection, resulting in 456,000 deaths. Prevention of TB requires prevention interventions for both HIV infection and TB, including HIV counseling and testing, disclosure and partner testing, behavior modification, earlier antiretroviral therapy, and the "Three I's for HIV/TB": isoniazid preventive treatment, intensified case finding, and infection control for TB. Managers of HIV programs should work with their colleagues in the TB field and the community to ensure that persons infected with HIV have access to the "Three I's for HIV/TB" as part of universal access to high-quality comprehensive prevention, care, and treatment of HIV infection and TB.