Impact of HIV infection on tuberculosis
- aCentre for Infectious Diseases, University College London, Royal Free and University College Medical School, Windeyer Institute of Medical Sciences, Room G41, 46 Cleveland Street, London W1P 6DB, UK, bPatrick Manson Ward, University College Hospital, London, UK, cImperial College School of Medicine, National Heart and Lung Institute, Dovehouse Street, London, UK
- Professor Zumla (e-mail:a.zumla{at}ucl.ac.uk)
- Received 24 March 1999
- Accepted 13 July 1999
Abstract
Tuberculosis is increasing in prevalence in many countries and is now the leading infectious cause of death world wide, being responsible for three million deaths annually. Infection with HIV, likewise increasing in prevalence, has emerged as the most important predisposing factor for developing overt tuberculosis in people co-infected with Mycobacterium tuberculosis. Owing to the widespread geographical overlap of these two infections, it is estimated that in 1999, HIV related tuberculosis will reach one million cases and will cause 30% of the expected 2.5 million AIDS related deaths. Tuberculosis in HIV infected individuals may have unusual clinical features and can cause diagnostic difficulties. Despite the effectiveness of modern short course treatment, the mortality of HIV related tuberculosis during and after treatment remains high, and this may be due to other HIV related infections. The “cursed duet” of infection with both HIV andM tuberculosis is generating a threat to human health of unparalleled proportions which, if not taken seriously by health workers and decision makers, could become totally unmanageable.
