HIV/AIDS and TB Co-Infection

Currently, about 42 million people are HIV-infected and almost one-third are also infected with TB. The dual epidemics of TB and HIV are particularly pervasive in Africa, where HIV has been the single most important factor contributing to the increasing incidence of TB over the last ten years; currently in many African countries more than 50% of patients with active TB disease are also HIV-positive. The dual epidemics are also of growing concern in Asia, where two-thirds of TB-infected people live and where TB now accounts for 40% of AIDS deaths. Eastern Europe and the Former Soviet Union have the fastest growing HIV epidemic in the world, and could particularly exacerbate problems with the MDR TB epidemic in the region of Eastern Europe and the former Soviet Union.

Persons infected with both HIV and TB are 30 times more likely to progress to active TB disease. Recent studies have shown that infection with TB enhances replication of HIV and may accelerate the progression of HIV infection to AIDS. Fortunately, TB treatment for HIV-positive patients under DOTS is just as effective as it is for people who are HIV-negative. In addition, clinical trials have shown that prophylaxis using anti-TB drugs can prevent or decrease the likelihood of TB infection from progressing to active TB disease in an HIV-infected person, making it an important intervention for increasing the length and quality of life of HIV-infected people, with benefits to their families and communities.

The objectives of USAID assistance in this area are to actively improve the coordination and harmonization of TB and HIV/AIDS interventions and programs to increase access to TB services (including TB screening and prophylaxis) for people infected with HIV, and increase access to HIV testing and other services for people infected with TB. In addition, USAID will increase the knowledge base, quality and availability of information on TB/HIV co-infections.

Learn more about USAID's Tuberculosis and HIV/AIDS programs.