PIP: Having radically and permanently altered the face of tuberculosis (TB) in Africa, HIV/AIDS is the major threat to TB control programs in Africa. As HIV prevalence rises, so will TB rates. TB rates will plateau once HIV infection does. The control of TB therefore partly depends upon the control of HIV transmission. The current epidemiological situation is described with regard to TB case notification, incidence estimates, and projections; TB and HIV co-infection; and evidence of the interaction between TB and HIV. The impact of HIV upon the clinical management of TB with regard to diagnostic obstacles and treatment complications is considered, followed by an examination of the threats and opportunities for National Tuberculosis Program activities in Africa in the context of HIV/AIDS. Community-based TB care approaches and the role of isoniazid preventive therapy in HIV-infected people are also considered.