Tuberculosis & HIV

Tuberculosis (TB) remains the leading cause of death among people living with HIV (PLHIV). In 2019, TB accounted for an estimated 30% of the 690 000 AIDS-related deaths in the world. These 208 000 deaths represented approximately 15% of the 1.4 million TB deaths that year.

According to the 2020 Global TB Report, PLHIV are 18 (15–21) times more likely to develop active TB disease than people without HIV. In 2019, of the estimated 10 million (range, 8.9–11.0 million) people who developed TB worldwide, 8.2% were PLHIV. Even when on antiretroviral therapy (ART), PLHIV are 3 times more likely to die during TB treatment, and continue to suffer disproportionately from this preventable and curable disease. In addition to early access to ART, high quality TB screening  and expanded use of TB preventive treatment are critical interventions to ensure that people with HIV receive timely treatment for TB disease or TB infection.

The new WHO guidelines on systematic TB screening  provide TB and HIV programmes with a range of new TB screening tools to enhance the early detection of TB among people with HIV. TB preventive treatment and ART have been proven to reduce TB incidence and mortality. However, only 50% of PLHIV initiating ART received TB preventive treatment in 2019 (from the subset of countries that reported) and only 41% of PLHIV estimated to have TB are receiving ART. HIV programmes must take measures to address these TB, diagnosis, prevention and treatment gaps among PLHIV, in order to reduce preventable TB incidence and mortality.