How is TB diagnosed and treated in patients with HIV infection?

Updated: Jan 07, 2019
  • Author: Julie B Zhao, MD; Chief Editor: Barry E Brenner, MD, PhD, FACEP  more...
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Tuberculin skin test (TST) is more likely to be negative in persons with HIV. Typically, interferon-gamma release assays (IGRAs) are the gold standard for identification of TB-infected individuals; however, in HIV patients, the sensitivity of IGRAs is diminished. In studies, IGRAs perform similarly to the TST. Since both methods have a modest predictive value and suboptimal sensitivity, the choice of test should be based on country guidelines and resource considerations. [14]

Recent studies have shown that the timing of HAART and tuberculosis therapy is important in those concurrently infected. Withholding HAART until the third week of anti-tuberculosis therapy likely reduced TB mortality. [15]

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