Concomitant Tuberculosis Infection in HIV-positive Patients

Abstract or Introduction

Mycobacterium tuberculosis (TB) and human immune deficiency virus (HIV) infections are two major public health problems in many parts of the world, particularly in many developing countries. TB is the most common opportunistic disease and cause of the death for those infected with HIV. Diagnosis of TB in HIV infected patients may be delayed because of atypical clinical presentation and involvement of inaccessible sites and low sputum smear positivity. Further, there has been an increase in rates of drug resistant tuberculosis, including multi-drug (MDR-TB) and extensively drug resistant TB (XDR-TB), which are difficult to treat and contribute to increased morbidity and mortality.

TB is the most common serious opportunistic infection in HIV positive patients and is the manifestation of AIDS in more than 50% of cases in developing countries. TB shortens the survival of patients afflicted with HIV infection, may accelerate the progression of HIV, and is the cause of death in one third of people with AIDS worldwide. While HIV and TB can individually be the major causes for public health threats, the combination of the two has proven to have a far greater impact on the epidemiologic progression and consequently on the global health scene.

Although the increased access to highly active antiretroviral therapy (HAART) has led to a reduction in HIV-associated opportunistic infections and hence mortality, but the concurrent management of HIV/TB co-infection remains a serious challenge to the health care delivery system. Discussion on the mechanisms produced by infectious cofactors with impact on disease pathology could shed light on how to design potential interventions that could decelerate disease progression. It is the need of the hour to design strategies against HIV-TB co-infection.

This book is based on my PG thesis work in Medical Microbiology written long bank, but in the current scenario the topic of TB-HIV co-infections holds relevance and is currently a burning issue. This has motivated me to convert my thesis in the form of a Book. The knowledge particularly in the field of medical sciences should not be restricted just to earn a University degree but should be disseminated in the entire scientific community so that medical fraternity including teachers, students, doctors, paramedics, researchers and above all the patients are benefitted. I am thankful to publications for giving me an opportunity to fulfil this dream.