Impact of HIV infection on tuberculosis

Tuberculosis is increasing in prevalence in many countries and is now the l eading infectious cause of death world wide, being responsible for three mi llion deaths annually. Infection with HIV, likewise increasing in prevalenc e, has emerged as the most important predisposing factor for developing ove rt tuberculosis in people co-infected with Mycobacterium tuberculosis. Owin g to the widespread geographical overlap of these two infections, it is est imated that in 1999, HIV related tuberculosis will reach one million cases and will cause 30% of the expected 2.5 million AIDS related deaths. Tubercu losis in HIV infected individuals may have unusual clinical features and ca n cause diagnostic difficulties. Despite the effectiveness of modern short course treatment, the mortality of HIV related tuberculosis during and afte r treatment remains high, and this may be due to other HIV related infectio ns. The "cursed duet" of infection with both HIV and M tuberculosis is gene rating a threat to human health of unparalleled proportions which, if not t aken seriously by health workers and decision makers, could become totally unmanageable.