LAUSR

https://jkms.org Mycobacterium tuberculosis (M.TB) infection in human immunodeficiency virus (HIV)-infected patients is one of the major opportunistic diseases, leading to severe morbidity and mortality. According to World Health Organization (WHO) tuberculosis (TB) reports,1 the number of patients with TB-HIV coinfection was 900,000 and the number of deaths was 300,000 in 2017. Comparing to the mortality rate of 16% due to TB in the general population, the percentage of deaths in TB-HIV patients was double at 33%. However, it is not easy to manage TB in immunocompromised hosts due to variable reasons: 1) vague symptoms related with TB, 2) low yields for microbiologic tests, 3) nontypical radiologic findings, 4) drug-drug interaction between anti-TB and anti-retroviral therapy (ART), 5) immune reconstitution inflammatory syndrome during the treatment, most of which are hurdles related with diagnosis. Therefore, the best strategy is to confirm and treat latent TB infection (LTBI), an early stage of TB infection that is characterized by a status of persistent immunity to M.TB antigen without manifestations of active disease, in HIV patients. Recently, WHO guidelines for LTBI2 also recommend that for adults living with HIV, LTBI should be treated in cases with unknown or a positive tuberculin skin test (TST) and without the evidence of active TB, irrespective of regional TB prevalence, the degree of immunosuppression, and use of ART.