HIV-Associated TB Syndemic: A Growing Clinical Challenge Worldwide

Area of Science:

• Infectious Diseases
• Public Health
• Global Health

Background:

• The co-occurrence of tuberculosis (TB) and human immunodeficiency virus (HIV) represents a significant and growing syndemic.
• People living with HIV (PLHIV) have a substantially higher risk of developing active TB disease from latent infection.
• Globalization and migration are increasing TB case detection in developed nations, not just endemic regions.

Purpose of the Study:

• To review the challenges and strategies for managing the TB-HIV syndemic.
• To emphasize the need for active TB screening in PLHIV.
• To highlight advancements in diagnostic tools and treatment recommendations.

Main Methods:

• Review of current literature on TB-HIV coinfection.
• Discussion of diagnostic challenges in paucibacillary TB among PLHIV.
• Evaluation of the role of GeneXPERT MTB/RIF assay in TB detection.

Main Results:

• HIV-Mycobacterium tuberculosis (MTB) coinfection is often difficult to diagnose with conventional methods.
• GeneXPERT MTB/RIF assay improves the detection of both pulmonary and extrapulmonary TB.
• The World Health Organization recommends immediate TB therapy alongside antiretroviral therapy.

Conclusions:

• Active TB screening in PLHIV is essential.
• A high index of suspicion for TB is warranted in PLHIV with relevant symptoms.
• Integrated HIV and TB services are a public health priority, especially in high-prevalence settings.