Epidemiology of HIV-associated tuberculosis.
OBJECTIVE
We review literature concerning the epidemiology of HIV-associated tuberculosis (HIV-TB), focusing on articles published between 2007 and 2008.


RESULTS
An estimated 1.37 million new cases of HIV-TB occurred in 2007, representing 15% of the total global burden of TB. In addition, an estimated 456 000 HIV-TB deaths accounted for 23% of global HIV/AIDS mortality. Sub-Saharan Africa is the worst affected region with 79% of the disease burden. The epicentre of the coepidemic lies in the south of the continent, with South Africa alone accounting for over one quarter of all cases. A critical overlap between HIV and the global multidrug-resistant TB epidemics is emerging. Although it is as yet unclear whether HIV is driving a disproportionate increase in multidrug-resistant TB cases at a population level, HIV has nevertheless been a potent risk factor for institutional outbreaks, especially in South Africa and eastern Europe. Increasing data have highlighted the risk of TB among HIV-infected healthcare workers in resource-limited settings. However, many studies also show the major benefits to be derived from antiretroviral therapy in high-income and low-income countries.


CONCLUSIONS
HIV-TB remains a major challenge to global health that requires substantial increases in resource allocation and concerted international action.
Lawn
Stephen D
SD
The Desmond Tutu HIV Centre, Institute for Infectious Disease and Molecular Medicine, University of Cape Town, Cape Town, Anzio Road, Observatory 7925, Cape Town, South Africa. stevelawn@yahoo.co.uk
Churchyard
Gavin
G
D017088:AIDS-Related Opportunistic Infections / Q000453:epidemiology*; D017954:Africa South of the Sahara / Q000453:epidemiology; D005061:Europe, Eastern / Q000453:epidemiology; D015658:HIV Infections / Q000150:complications*; D006801:Humans; D013019:South Africa / Q000453:epidemiology; D014376:Tuberculosis / Q000453:epidemiology*