In HIV infected patients, tuberculosis is the leading cause of death through
the world. According to some World Health Organization (WHO) reports, the risk of
tuberculosis disease in People Living with HIV (PLHIV) is about 10-20 times greater
than people without HIV. The risk of developing tuberculosis disease in PPD positive
HIV infected is about 10% annually but in HIV un-infected people is about 10%
throughout their life. HIV accelerates the progression of tuberculosis infection toward
disease both in recent and latent infection of TB. Pulmonary tuberculosis is the most
common type of TB and its symptoms are related to the immune status of the patients
and the level of progression to AIDS. Usually, signs and symptoms of tuberculosis are
mild and it is difficult to diagnose. In smear negative pulmonary TB which is mostly
observed in advanced HIV infection, mortality and morbidity would be higher due to
the delay in establishing the diagnosis. Considering that reactivation of Latent TB
(LTB) to active tuberculosis is more prevalent in PLHIV compared to HIV negative
people, the diagnosis of LTB infection would be an important priority and screenings
for TB should be done periodically among PLHIV as a priority. Any PLHIV with
suspected LTB is eligible for isoniazid (INH) prophylaxis. All PLHIV with
tuberculosis disease should be under Antiretroviral Therapy (ART) irrespective of CD4
cell count.
Keywords: AFB, AIDS, ART, CD4 cell, LTB, PLHIV, Prophylaxis, PPD, Tuberculosis, XDR-TB.