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. 2021 Aug;32(9):780-790.
doi: 10.1177/0956462421992257. Epub 2021 Feb 20.

HIV-associated tuberculosis

Yohhei Hamada  1   2 , Haileyesus Getahun  3 , Birkneh Tilahun Tadesse  3 , Nathan Ford  4
Affiliations

HIV-associated tuberculosis

Yohhei Hamada et al. Int J STD AIDS. 2021 Aug.

Abstract

Tuberculosis (TB) remains a leading cause of morbidity and mortality among people living with HIV. HIV-associated TB disproportionally affects African countries, particularly vulnerable groups at risk for both TB and HIV. Currently available TB diagnostics perform poorly in people living with HIV; however, new diagnostics such as Xpert Ultra and lateral flow urine lipoarabinomannan assays can greatly facilitate diagnosis of TB in people living with HIV. TB preventive treatment has been underutilized despite its proven benefits independent of antiretroviral therapy (ART). Shorter regimens using rifapentine can support increased availability and scale-up. Mortality is high in people with HIV-associated TB, and timely initiation of ART is critical. Programs should provide decentralized and integrated TB and HIV care in settings with high burden of both diseases to improve access to services that diagnose TB and HIV as early as possible. The new prevention and diagnosis tools recently recommended by WHO offer an immense opportunity to advance our fight against HIV-associated TB. They should be made widely available and scaled up rapidly supported by adequate funding with robust monitoring of the uptake to advance global TB elimination.

Keywords: AIDS; antiretroviral treatment; drug-resistant tuberculosis; preventive treatment.

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Conflict of interest statement

Declaration of conflicting interests: The author(s) declared no potential conflicts of interest with respect to the research, authorship, and/or publication of this article.

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