Does TB alter the natural course of HIV infection?
Findings from several studies suggest that active TB may accelerate HIV- induced immunological deterioration. The evidence is as follows: (1) Active TB is associated with transient CD4+ T-lymphocyte depletion; (2) TB causes immune stimulation and increased production of cytokines, such as tumour necrosis factor (TNF) which increases HIV replication in vitro, and (3) HIV-infected persons with TB appear to have a higher risk of opportunistic infections and death than do HIV-infected patients with similar CD4+ T-lymphocyte counts but without TB.
