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Review
. 2009 Jul;4(4):325-33.
doi: 10.1097/COH.0b013e32832c7d61.

Epidemiology of HIV-associated tuberculosis

Stephen D Lawn  1 , Gavin Churchyard
Affiliations
Review

Epidemiology of HIV-associated tuberculosis

Stephen D Lawn et al. Curr Opin HIV AIDS. 2009 Jul.

Abstract

Purpose of review: We review literature concerning the epidemiology of HIV-associated tuberculosis (HIV-TB), focusing on articles published between 2007 and 2008.

Recent findings: An estimated 1.37 million new cases of HIV-TB occurred in 2007, representing 15% of the total global burden of TB. In addition, an estimated 456 000 HIV-TB deaths accounted for 23% of global HIV/AIDS mortality. Sub-Saharan Africa is the worst affected region with 79% of the disease burden. The epicentre of the coepidemic lies in the south of the continent, with South Africa alone accounting for over one quarter of all cases. A critical overlap between HIV and the global multidrug-resistant TB epidemics is emerging. Although it is as yet unclear whether HIV is driving a disproportionate increase in multidrug-resistant TB cases at a population level, HIV has nevertheless been a potent risk factor for institutional outbreaks, especially in South Africa and eastern Europe. Increasing data have highlighted the risk of TB among HIV-infected healthcare workers in resource-limited settings. However, many studies also show the major benefits to be derived from antiretroviral therapy in high-income and low-income countries.

Summary: HIV-TB remains a major challenge to global health that requires substantial increases in resource allocation and concerted international action.

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Figures

Figure 1
Figure 1. Country estimates of the prevalence of HIV infection in new cases of tuberculosis (TB) diagnosed in 2005.
Source: World Health Organization (WHO), Geneva, 2006. Available at: http://gamapserver.who.int/mapLibrary/ The boundaries and names shown and the designations used on this map do not imply the expression of any opinion whatsoever on the part of the WHO concerning the legal status of any country or territory or concerning the delimitation of its frontiers or boundaries.
Figure 2
Figure 2. Geographical distribution of estimated HIV-associated TB cases in 2006.
For each country or region, the estimated number of cases is shown as a percentage of the global total. AFR* represents all countries in the WHO African region except for those shown separately. AMR* is the WHO Region of the Americas, excluding Brazil. EUR* is the WHO European Region, excluding the Russian Federation. SEAR* is the WHO South-East Asia Region, excluding India. Source: WHO, 2008 [4*].
Figure 3
Figure 3. Trends in estimated tuberculosis incidence rates (per 100,000 per year) for the period 1990-2006.
Data are from the 134 countries with the most reliable surveillance systems. Global data and data from nine sub-regions are shown. Source: WHO, 2008 [4*].
See this image and copyright information in PMC

References

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    1. World Health Organization . Global tuberculosis control, 2009. Epidemiology, strategy, financing. World Health Organization; Geneva: WHO/HTM/TB/2009.411. [** A comprehensive overview of the burden of TB at global, regional and national levels with data available up to 2007. In this report, increasing availability of data have permitted the estimates of the burden of HIV-TB to be revised. These find almost double the number of cases occur each year than was previously estimated.]
    1. World Health Organization . Global Tuberculosis Control. Surveillance, planning and financing. World Health Organization; Geneva: 2008. WHO/HTM/TB/2008.393. [* A comprehensive annual overview of the burden of tuberculosis at the global, regional and national levels using data available up to 2006.]
    1. Lazarus JV, Olsen M, Ditiu L, Matic S. Tuberculosis-HIV co-infection: policy and epidemiology in 25 countries in the WHO European region. HIV Med. 2008;9:406–14. [* This paper highlights the rising trends in the burden of HIV-associated tuberculosis in several European countries,] - PubMed

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