TB and HIV are closely interlinked. TB is a leading cause of HIV-related morbidity and mortality. HIV is the most important factor fuelling the TB epidemic in populations with a high HIV prevalence. Collaboration between TB and HIV/AIDS programmes is crucial in supporting general health services providers. These providers need support in delivering the full range of HIV and TB prevention and care interventions. To counteract the impact of HIV on TB, other interventions are required apart from effective TB case-finding and cure. These interventions include:

•  Measures to decrease HIV transmission (e.g. promotion of condoms, treatment of sexually transmitted infections, voluntary counseling and HIV testing, safe intravenous drug use, reduction in the number of sexual partners, prevention of mother to child HIV transmission, HIV screening of blood for transfusion and application of universal HIV precautions by health care workers).

• Antiretroviral therapy (ART) (to improve or maintain immune function in people living with HIV infection)

• Care for people living with HIV infection (e.g. treatment of HIV-related diseases, prevention of HIV-related infections, TB prevention, palliative care and nutritional support).

Facts on TB and HIV/AIDS  

HIV increases a person’s susceptibility to infection with Mycobacterium tuberculosis.
In a person infected with M. Tuberculosis, HIV is a potential cause of progression of tuberculosis infection to active diseases.

An individual infected with HIV, has a 30-50 times increased risk of developing TB, than a person who is not infected with HIV.

One-third (>12 million) people are dually infected with TB and HIV globally.

SAARC bears about 17 % of Global TB and HIV co-infection cases

In HIV infections the immune system is less able to prevent the growth and local spread of M. tuberculosis. Therefore disseminated and extra pulmonary TB disease is more common compared with the pulmonary TB.

Weight loss and fever are more common in HIV positive patients than in those who are HIV negative. Conversely cough and haemoptysis are less common in HIV positive Pulmonary TB patients than in those who are HIV negative.

Lung lesions or clinical picture of Pulmonary TB patients varies according to the stage of HIV infection.

In early stage of HIV infection pulmonary TB often resembles post-primary TB with cavitations of lungs. Sputum smear result is always positive.

In late stage HIV infections pulmonary TB often resembles primary TB with infiltrating lung lesions with no cavitations. Sputum smear result is always negative.

Chest X-Ray changes in the TB/HIV patients reflect the degree of immunocompromise. In early stage of HIV infection (mild immunocompromise) the appearance is often classical with cavitations and upper lobe infiltration. In late stage of HIV infections (severe immunocompromise) the appearance is often a typical.

Case fatality is less in TB/HIV patients treated with short course chemotherapy, yet it is higher than the HIV negative TB patients.

More HIV infected people die due to TB than due to any other opportunistic infection.

Increased incidence of adverse drug reactions may lead to interruption of treatment; facilitating emergence of drug resistant cases among TB/HIV patients.