Human Immunodeficiency Virus, Mycobacterium Tuberculosis, and Pregnancy: A Deadly Combination

Abstract

Mycobacterium tuberculosis is estimated to infect 30% of the world population with 95% of tuberculosis (TB) cases and 98% of TB deaths occurring in resource-limited countries. Superimposed on this burden of TB is HIV infection which has reached pandemic proportions in areas where TB is endemic. TB and HIV are inextricably linked. The development of TB disease has been linked to increased HIV replication and reduced CD4 cell counts potentially contributing to the progression of HIV infection. In the Womens Interagency HIV Study which has followed a cohort of HIV-infected women in the United States for a median of 6 years the development of TB disease was associated with a 4-fold increase in AIDS-related mortality. Moreover immunodeficiency induced by HIV fuels TB resurgence and increases TB incidence and mortality in areas where TB is highly prevalent; HIV infection is associated with a >/= 20-fold increased risk of reactivation of latent TB and is thought to account for much of the increase in the global burden of TB observed over the past 2 decades. (excerpt)