Current Infectious Disease Reports

, Volume 15, Issue 1, pp 77–84

The Twin Epidemics of Tuberculosis and HIV

  • George M. Varghese
  • Jeshina Janardhanan
  • Ravikar Ralph
  • Ooriapadickal C. Abraham
HIV/AIDS (R MacArthur, Section Editor)

DOI: 10.1007/s11908-012-0311-3

Cite this article as:
Varghese, G.M., Janardhanan, J., Ralph, R. et al. Curr Infect Dis Rep (2013) 15: 77. doi:10.1007/s11908-012-0311-3

Abstract

The deadly combination of tuberculosis (TB) and human immunodeficiency virus (HIV) currently ravaging the world, taking a toll of about 0.35 million people every year, is one of the major public health crises of the decade. Throughout the course of HIV infection, the risk of acquisition, reactivation, and reinfection of TB keeps increasing substantially as the immune deficiency progresses. TB coinfected patients inadvertently facilitate HIV infection by release of the proinflammatory cytokines and overexpression of coreceptors CXCR4 and CCR5; thereby, the progression of each is facilitated. The difficulties in diagnosing active tuberculosis in HIV-infected individuals poses a great challenge that is further complicated by the challenges in identification of latent TB infection, creating a setback to preventive therapy. Furthermore, prescribing antituberculous therapy and antiretroviral therapy together poses several management challenges, including drug interactions, added toxicities, and TB immune reconstitution inflammatory syndrome. The current approach to diagnosis, prevention, and treatment strategies in TB and HIV coinfected individuals, along with epidemiology and overview of pathogenetic interplay of both microbes, is reviewed here.

Keywords

Tuberculosis HIV Twin epidemics TB HIV coinfection 

Copyright information

© Springer Science+Business Media New York 2013

Authors and Affiliations

  • George M. Varghese
    • 1
  • Jeshina Janardhanan
    • 1
  • Ravikar Ralph
    • 1
  • Ooriapadickal C. Abraham
    • 1
  1. 1.Department of Medicine 1 & Infectious DiseasesChristian Medical CollegeVelloreIndia

Personalised recommendations