Human Immunodeficiency Virus Infection and Acquired Immunodeficiency Syndrome assosiated with TB

HIV infection and AIDS have contributed to the rising case rates of tuberculosis through three broad pathways. First, individuals with latent tuberculosis infection who acquire HIV infection are at much greater risk of reactivation as their immune capacity diminishes. Second, persons with HIV infection or AIDS may well be at higher risk of acquiring new tuberculosis infections, probably because of biologic factors (e.g., impaired defenses) and situational factors (e.g., more time spent in high-risk, congregate environments, including hospitals). Third, young adults with HIV infection and active tuberculosis transmit tuberculosis to people with whom they reside. The upsurge in tuberculosis cases in the United States since 1985 has presumably been linked to the HIV epidemic, although full quantification of the association is not possible because of incomplete serologic testing. However, there can be no question that HIV/AIDS is playing a major role in rising case rates in many regions of the world, including sub-Saharan Africa, Russia, and Southeast Asia.