(Last updated 9/1/2016; last reviewed 9/1/2016)
Tuberculosis (TB) is a contagious disease that can spread from person to person. TB is caused by bacteria called Mycobacterium tuberculosis. The TB bacteria spread in the air.
TB usually affects the lungs. But TB-causing bacteria can attack any part of the body, including the kidneys, spine, or brain. If not treated, TB can cause death.
A person with TB disease of the lungs or throat can spread droplets of TB bacteria in the air, particularly when they cough or sneeze. People who breathe in the TB bacteria can get TB.
Once in the body, TB can be inactive or active. Inactive TB is called latent TB. Active TB is called TB disease. The image below shows the difference between latent TB and TB disease.
TB is an opportunistic infection (OI). OIs are infections that occur more often or are more severe in people with weakened immune systems than in people with healthy immune systems. HIV weakens the immune system, increasing the risk of TB in people with HIV.
Infection with both HIV and TB is called HIV/TB coinfection. In people with HIV, latent TB is more likely to advance to TB disease. TB disease may also cause HIV to worsen.
Treatment with HIV medicines is called antiretroviral therapy (ART). ART protects the immune system and prevents HIV infection from advancing to AIDS.
ART also has TB-related benefits:
Worldwide, TB disease is one of the leading causes of death among people with HIV. In the United States, where HIV medicines are widely used, fewer people with HIV get TB than in many other countries. But TB still affects many people with HIV in the United States, especially those born outside the United States.
Yes, people with HIV should get tested for TB infection. If test results show that a person has latent TB, additional testing is needed. More testing will determine whether the person has TB disease.
People with latent TB don’t have any signs of the disease. But if latent TB advances to TB disease, there will usually be signs of the disease. Common symptoms of TB disease include:
In general, TB treatment is the same for people infected with HIV and people not infected with HIV. TB medicines are used to prevent latent TB from advancing to TB disease and to treat TB disease. The choice of TB medicines and the length of treatment depend on whether a person has latent TB or TB disease.
People with HIV/TB coinfection should be treated for both diseases. In most cases, HIV and TB can be treated at the same time. Taking HIV and TB medicines at the same time can increase the risk of drug-drug interactions and side effects. People being treated for HIV/TB coinfection are carefully monitored by their health care providers.
The choice of medicines to treat HIV/TB coinfection depends on a person’s individual circumstances. For example, some medicines can’t be safely used during pregnancy. If you have HIV/TB coinfection, talk to your health care provider about the best medicines for you.
From the Centers for Disease Control and Prevention (CDC):