HIV coinfection with tuberculosis epidemiology and demographics

Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]

• About 1.1 million individuals were living with HIV infection at the end of 2006. As many as 21% of infected people are unaware of having the infection.
• It is estimated that about 4.2% of Americans with or without HIV infection are infected with the TB bacteria. In 2009 there were approximately 13 million Americans with latent TB infection (LTBI).
• In 2009, among persons with TB who had a documented HIV test result, more than 10% (690 of 6,743) were co-infected with HIV.
• In 2006, the HIV status of 1 in 5 patients with TB was not known, even though CDC recommends that all persons with TB be tested for HIV.
• In 2006, nearly 20% of patients with TB and HIV died. Persons with HIV and TB accounted for 32% of those who died during TB treatment and 51% of those who received a TB diagnosis after death.
• In 2005, of the TB patients reported to be co-infected with HIV, 63% were non-Hispanic blacks.
• World Health Organization (WHO) has reported that the risk of developing TB is approximately 16-27 times greater in HIV-infected individuals than in those without HIV infection.
• In 2015, WHO reported approximately 10.4 million cases of TB disease worldwide. Out of them, 1.2 million [11%] were having HIV infection. About 60% of TB cases among people having HIV infection were not diagnosed or treated, leading to approximately 390,000 TB-related deaths among people living with HIV in 2015.
• The relative risk of tuberculosis among people with HIV infection increases exponentially as CD4+ T-lymphocyte counts decline.
• The risk is increased by a factor of more than 25 when the CD4+ T-lymphocyte count is less than 200 per microliter, as compared with a count of 1000 per microliter.
• Southern Africa and East Africa were the worst affected; in South Africa, the incidence increased by a factor of more than 3 during the 1990s and early 2000s.

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