HIV and Opportunistic Infections, Coinfections, and Conditions
HIV and Tuberculosis (TB)
Last Reviewed: July 26, 2017
- Tuberculosis (TB) is a disease caused by bacteria that spread in the air. TB can spread from person to person.
- Once in the body, TB can be inactive or active. Inactive TB is called latent TB. Active TB is called TB disease.
- 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 disease can cause death.
- HIV weakens the immune system, increasing the risk of TB in people with HIV.
- People who have both HIV and TB should be treated for both diseases. The choice of medicines to treat HIV/TB coinfection depends on a person’s individual circumstances.
What is tuberculosis?
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.
How does TB spread from person to person?
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.
What is the connection between HIV and TB?
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. Latent TB is more likely to advance to TB disease in people with HIV than in people without HIV. 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:
- ART reduces the risk of TB infection in people with HIV.
- ART reduces the chances that latent TB will advance to TB disease in people with HIV/TB coinfection.
How common is HIV/TB coinfection?
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.
Should people with HIV get tested for TB?
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.
What are the symptoms of TB?
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:
- A persistent cough that may bring up blood or sputum
- Weight loss
- Night sweats
What is the treatment for TB?
In general, TB treatment is the same for people with HIV and people without 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.
Learn more about HIV and TB. This fact sheet is based on information from the following sources:
From the Centers for Disease Control and Prevention (CDC):
- Guidelines for the Prevention and Treatment of Opportunistic Infections in HIV-Infected Adults and Adolescents: Mycobacterium Tuberculosis Infection and Disease
- Guidelines for the Use of Antiretroviral Agents in Adults and Adolescents Living with HIV: Mycobacterium Tuberculosis Disease with HIV Coinfection
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