Tuberculosis in People With HIV

Topic Overview

People who are infected with the human immunodeficiency virus (HIV) have an increased risk for developing tuberculosis (TB). Their risk for TB doubles in the first year they developed the HIV infection.^{footnote 1}

If they have latent TB, which cannot be spread to others, they are at risk for the infection becoming an active disease, which can be spread to others. Active TB in the lungs also is more likely to spread to other parts of the body (extrapulmonary TB) in people who have HIV infection than in people who do not have it.

Both active and latent TB are sometimes difficult to diagnose in people who also are infected with HIV or who have AIDS.

• TB skin tests sometimes do not detect an infection in people who have AIDS or HIV infection even when they have TB. This is because their immune systems often do not work well enough to respond to a skin test.
• Active TB symptoms may be similar to common AIDS symptoms (weight loss, night sweats, fever, and fatigue).
• Some lung infections common in AIDS, such as Pneumocystis pneumonia, may mask the signs of TB on chest X-rays.

Tuberculosis can be the first sign of an HIV infection or AIDS.

• When people are diagnosed with active or latent TB, they should have a test for HIV.
• When people are diagnosed with HIV, they also should have a test for TB.

Active TB may speed the progression of HIV in people who are infected with both diseases and also may increase their risk of dying from the HIV infection. People who have both diseases may be at increased risk for developing multidrug-resistant TB. For these reasons, it is important to promptly treat people who have HIV infection and TB. With treatment, latent and active TB usually can be cured in people who have HIV or AIDS.