Tuberculosis and HIV: What’s the Connection?
Tuberculosis (TB) is a disease that usually affects the lungs. It can also affect other parts of the body, such as the brain, kidneys, or spine.
TB is a serious threat, especially for people living with HIV. That’s because people living with HIV are more likely than others to become sick with TB.
Worldwide, TB is one of the leading causes of death among people living with HIV.
How Is TB Spread?
TB germs are spread from person to person through the air. TB germs are put into the air when a person with TB disease of the lungs or throat coughs, laughs, or sings. People nearby may breathe in the germs and become infected.
TB is NOT spread by sharing silverware or cups, or sharing saliva when kissing someone.
What’s the Difference between Latent TB Infection and TB Disease?
There are two types of TB-related conditions: latent TB infection and TB disease.
Latent TB Infection
Not everyone who is infected with TB germs gets sick. People who are infected but are not sick have what is called latent TB infection. People with latent TB infection:
- Do not have symptoms
- Don’t feel sick
- Can’t spread TB germs to others
- Usually have a positive TB skin text reaction or positive TB blood test
Without treatment, people with latent TB infection can develop TB disease. This is especially true for people living with HIV because their immune system is already weak. A person living with HIV who has untreated latent TB infection is much more likely to develop TB disease during his or her lifetime than a person without HIV infection.
Fortunately, treatment is available. Learn about Treatment.
When TB germs are active (multiplying in your body), this is called TB disease. People with TB disease are sick. They may also be able to spread TB germs to people they spend time with every day.
A person who has both HIV infection and TB disease has an AIDS-defining condition.
It is important to get treatment for TB disease. Without treatment, TB disease can progress from sickness to death. Learn about Treatment.
How Do I Know If I Have Latent TB Infection or TB Disease?
There are two kinds of tests that are used to find out if you have TB germs in your body: a TB skin test and a TB blood test. You can get either of these tests at the health department or at your healthcare provider’s office.
A positive TB skin test or TB blood test only tells that you have been infected with TB germs. If either of these tests is positive, it does not tell whether you have latent TB infection or TB disease. You will need other tests, such as a chest x-ray and a sample of sputum, to know whether you have TB disease.
If you are a person living with HIV, it is very important to get a TB test. This will help your physician know how to treat both your TB and HIV infections.
CDC strongly recommends that all people who are newly diagnosed with HIV be tested for TB as soon as possible, and that people whose initial test is negative and who are at high risk for TB exposure be tested at least annually. Learn more about TB testing and diagnosis.
How Is TB Treated?
People living with HIV who also have either latent TB infection or TB disease can be effectively treated with TB medication. The TB medicine is the only way to kill the TB germs in your body. There are specific TB medication plans for latent TB infection and for TB disease. Treatment for latent TB infection will prevent the development of TB disease. Treatment for TB disease is needed to cure the disease and prevent spread to others. Talk with your healthcare provider about a treatment plan that is right for you.
Treatment for TB can be challenging. You will need to take all your pills the right way, exactly as your healthcare provider tells you. If not, the treatment may be longer, more difficult, or not work at all.
You will also need to see your healthcare provider regularly during your treatment to make sure you are not hurt by side effects from taking TB and HIV medicines together. Learn more about TB treatment.
Sometimes drug-resistant TB occurs when germs become resistant to the drugs used to treat TB. This means that the drugs can no longer kill the TB germs.
Drug resistance is more common in people who:
- Do not take their TB drugs regularly
- Do not take all of their TB drugs
- Develop TB disease again, after having been treated for TB diseases in the past
- Come from areas of the world where drug-resistant TB is common
- Have spent time with someone known to have drug-resistant TB disease
Multidrug-resistant TB (MDR TB) is TB that is resistant to at least two of the most potent anti-TB drugs—isoniazid and rifampin. MDR TB is extremely difficult to treat and can be fatal.
Extensively Drug-Resistant Tuberculosis (XDR TB) is a rare type of MDR TB that is resistant to the most powerful first-line and second-line drugs.
MDR and XDR TB are of special concern to people living with HIV or others with weakened immune systems. Learn more about Drug-resistant TB.
Last revised: 03/15/2017