Pathogenesis and management of HIV/TB co-infection in Asia

HIV infection increases the risk of reactivation of latent tuberculosis (TB), progression of a new infection or re-infection to active disease, and acceleration of the natural course of the disease with a more rapid spread of strains, including those that are drug resistant, in the community. TB also accelerates the course of HIV-induced disease by activating viral replication and accentuating the decline in CD4 T cell counts. In this chapter, TB-HIV co-infection is discussed in the context of the situation in Vietnam, particularly Ho Chi Minh City, the creation of a well-integrated TB control and research programs in Cambodia, and the broad principles of the co-management of TB/HIV particularly in the context of the associated atypical forms of pulmonary TB (PTB), increased non-PTB and the frequency of acid fast smear negative cases.