TB and HIV

Tuberculosis (TB) is a leading killer among people living with HIV. People suffering from TB/HIV coinfection are at higher risk of failing treatment and have a higher risk of dying than people with TB disease only.

HIV and TB form a deadly combination, each accelerating the other's progress. The risk of developing TB is far greater for people living with HIV. One in three people coinfected with TB/HIV do not know about their status, which drastically lowers their chances of being cured of TB. In turn, this favours the spread of the diseases, putting health systems and governments under pressure.

In 2011–2015, new TB cases and deaths continued to decline in the WHO European Region, but new TB/HIV coinfections increased by 40%. This is of special concern in a region where HIV cumulative cases reached over 2 million for the first time in 2015. The sharp increase of TB/HIV coinfections, together with persistently high rates of drug-resistant TB, seriously threaten progress made towards ending TB.

Main populations at risk for HIV and HIV-associated TB

  • People who inject drugs (PWID) and their sex partners. PWID often engage in sex work to support their injecting habit, which increases the risk of HIV transmission to the general population.
  • Sex workers, because of behaviours such as unsafe sex and unsafe injecting drug use practices. Sex workers may represent a significant channel of HIV transmission to the general population.
  • Men who have sex with men and transgender people having unsafe sex.

Addressing TB/HIV coinfection

Targeted interventions for early detection and universal access to free-of-charge treatment and care of both HIV and TB are crucial to contain and reduce coinfection. Coordination and collaboration of HIV and TB services are essential for the effective delivery of these interventions.

World TB Day 2017: Focus on TB/HIV coinfection

WHO policy on collaborative TB/HIV activities (2012)

Integrating collaborative TB and HIV services within a comprehensive package of care for people who inject drugs. Consolidated guidelines (2016)

Guidelines for intensified tuberculosis case finding and isoniazid preventive therapy for people living with HIV in resource-constrained settings (2011)

Algorithm for managing people living with HIV who are suspected of having TB

Consolidated guidelines on the use of antiretroviral drugs for treating and preventing HIV infection. Recommendations for a public health approach. Second edition (2016)

Infographic – TB/HIV coinfection in the WHO European Region (World TB Day 2017)

Photo story – Putting people at the centre: integrated treatment for HIV, tuberculosis and drug dependence in Portugal