TB is classified as an opportunistic infection (OI), meaning it occurs more frequently and severely in people with weakened immune systems, such as those with HIV. HIV weakens the immune system, making people more susceptible to TB.
Infection with both HIV and TB is referred to as HIV/TB coinfection. People with untreated latent TB infection are more likely to develop active TB disease if they have HIV. In HIV-positive individuals, TB disease is considered an AIDS-defining condition, which includes infections and cancers that are life-threatening in people with HIV.
Understanding Tuberculosis (TB)
Tuberculosis (TB) is a disease caused by the bacterium Mycobacterium tuberculosis. This bacterium spreads through the air from person to person, primarily affecting the lungs, but it can also impact other parts of the body, such as the kidneys, spine, or brain. Without treatment, TB can be fatal.
How TB Spreads
When an individual with active TB of the lungs coughs or speaks, droplets containing the TB bacteria are released into the air. Nearby people who inhale these droplets can become infected. TB infection can exist in two states: latent and active.
- Latent TB Infection: The TB bacteria are present in the body but inactive. Individuals do not feel sick, show symptoms, or spread TB. However, latent TB can progress to active TB disease.
- Active TB Disease: The bacteria are active and multiplying in the body. This form of TB makes individuals feel sick, exhibit symptoms, and can spread to others. Without treatment, active TB can be deadly.
Impact of Antiretroviral Therapy (ART)
ART, the treatment with HIV medicines, is crucial as it protects the immune system and prevents HIV from progressing to acquired immunodeficiency syndrome (AIDS). For individuals with HIV and latent TB infection, treatment with both HIV and TB medicines significantly reduces the likelihood of latent TB advancing to active TB disease.
Prevalence of HIV/TB Coinfection
Globally, TB is one of the leading causes of death among people with HIV. In the United States, the widespread use of HIV medicines has reduced the incidence of TB among people with HIV, but it remains a concern, especially among those born outside the United States.
Testing for TB in People with HIV
It is recommended that all people with HIV undergo testing for TB infection. If results indicate latent TB infection, further testing is necessary to determine if the person has progressed to active TB disease.
Symptoms of TB
- Latent TB Infection: No symptoms.
- Active TB Disease (Lungs): Persistent cough (potentially producing blood or sputum), chest pain, weakness, fatigue, loss of appetite, weight loss, chills, fever, and night sweats.
- TB Disease (Other Body Parts): Symptoms vary depending on the affected area.
Treatment for TB
TB medicines are used to prevent latent TB infection from becoming active TB disease and to treat active TB. The specific medications and duration of treatment depend on whether the infection is latent or active.
Managing HIV/TB Coinfection
For those with HIV/TB coinfection, simultaneous treatment of both HIV and TB is essential. The timing of treatment initiation and choice of medicines depend on individual circumstances, as certain combinations of HIV and TB medications can lead to drug interactions and side effects. Close monitoring by healthcare providers is necessary.
If you have HIV/TB coinfection, discuss with your healthcare provider to develop a tailored treatment plan that addresses both conditions effectively.