INTRODUCTIONOne of the commonest opportunistic infections (OIs) in HIV infected individuals in developing countries, including India, is tuberculosis (TB). The recent WHO report states that of the 2.8 million TB infections in India in 2015, around 4% were among HIV positive individuals.There is a vast body of evidence indicating dysregulated immune responses in HIV infection. The modulation of host immunity in TB is also well established. When these two diseases converge, the consequences are devastating, resulting in significant morbidity and mortality. Studies have shown that the risk of developing active TB increases in individuals with HIV. Active TB disease also causes an exacerbated course of HIV infection.HIV infection has brought with it increasing cases of extrapulmonary TB, involving multiple organs with poor‐formed granulomas. The likelihood of HIV‐infected individuals developing TB of the CNS is five times more than those negative for HIV. HIV alters the immune response to M. tuberculosis in multiple ways. Lower CD4 T cell counts are associated with higher rate of TB reactivation, especially CD4 T cell counts <200 μL which result in increased susceptibility to disseminated TB. Well‐defined granulomas are lacking in these patients, resulting in ineffective containment of the infection. The most severe form of
Journal of Medical Virology – Wiley
Published: Jan 1, 2018
Keywords: ; ; ; ;
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