Diagnostic Dilemma of Tuberculosis among HIV-positive patients: Challenges and Advances

Abstract

HIV/TB co-infection presents a significant public health challenge due to the synergistic interaction between the twopathogens. HIV weakens the immune system, making individuals more susceptible to TB infection and reactivationof latent TB. Conversely, active TB accelerates the progression of HIV to AIDS by further compromising immunefunction, increasing viral replication, and promoting viral mutation. This interaction not only worsens clinical outcomesbut also increases mortality rates among people living with HIV (PLWH). The mutual enhancement of these pathogensmeans that HIV infection increases the likelihood of TB infection and reactivation due to the compromised immunesystem. TB infection, in turn, accelerates the deterioration of immune function in PLWH, leading to faster progressionto AIDS. Active TB is a leading cause of death among PLWH. In 2019, approximately 33% of the 690,000 AIDS-related deaths were attributable to HIV-associated TB.