HIV coinfection with tuberculosis pathophysiology

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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]

Overview

People infected with HIV (the virus that causes AIDS) are more likely than uninfected people to get sick with other infections and diseases. Tuberculosis (TB) is one of these diseases. TB is a disease that usually affects the lungs. It sometimes affects other parts of the body, such as the brain, the kidneys, or the spine.

Pathophysiology

HIV infection weakens the immune system. If a person’s immune system gets weak, TB infection can activate and become TB disease. Someone with TB infection and HIV infection has a very high risk of developing TB disease. Without treatment, these two infections can work together, to shorten the life of the person infected with both.

Do all people with HIV get TB disease?

No, but it does increases the chance of getting TB disease if patient have both TB infection and HIV infection. For this reason, if patient have HIV infection, the doctor must also get a TB skin test.

What is the difference between latent TB infection and active TB disease?

TB is spread through the air from one person to another. The bacteria are put into the air when a person with TB disease of the lungs or throat coughs or sneezes. People nearby may breathe in these bacteria and become infected. However, not everyone infected with TB bacteria becomes sick. As a result, two TB-related conditions exist: latent TB infection and active TB disease.

In most people who breathe in TB bacteria and become infected, the body is able to fight the bacteria and stop them from growing. The bacteria become inactive, but they remain alive in the body and can become active later. This is called latent TB infection. However, TB bacteria can become active if the immune system can’t stop them from growing. These bacteria begin to multiply in the body and cause active TB disease.

There are an estimated 9 to 14 million persons in the United States infected with TB bacteria. Most people who have latent TB infection never develop active TB disease. In these people, the TB bacteria remain inactive for a lifetime without causing disease. A person with latent TB infection does not feel sick and cannot spread TB bacteria to others. Because HIV weakens the immune system, people with latent TB infection and HIV infection are at very high risk of developing active TB disease. These bacteria begin to multiply in the body and cause active TB disease.

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