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Br Med Bull. 1998;54(3):579-93.

Resurgence of tuberculosis and the impact of HIV infection.

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Department of Infectious and Tropical Diseases, London School of Hygiene and Tropical Medicine, London, UK.


Tuberculosis is increasing in many countries. In some areas the major influences on tuberculosis trends are the traditional ones: poverty, failures in the treatment system, and immigration. In others, and increasingly, the HIV epidemic is having a huge impact. HIV infection increases the risk of tuberculosis approximately 7-fold, though this may vary with the stage of the HIV epidemic, the prevalence of tuberculosis, and the age groups considered. Dually-infected individuals develop tuberculous disease at a rate of 5-10% per year. HIV also increases the risk of disease following recent infection, which makes a major contribution to the tuberculosis burden in some settings. HIV-infected individuals, may transmit Mycobacterium tuberculosis less than do HIV-negative individuals, but the extra cases will add to the transmission overall, and evidence of HIV-attributable increases in the annual risk of infection is beginning to be seen.

[Indexed for MEDLINE]

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