Authors: Emanuele Pontali , Federica Toscanini , Giovanni Battista Migliori
In spite of the global efforts, tuberculosis (TB) and HIV infection remain two major challenges in global health. TB has become the leading cause of death from an infectious diseases (ninth cause of death globally), while HIV follows ranking as the second . In particular, TB is the leading cause of death among people with HIV, accounting for some 370,000 individuals who died as a result of HIV-associated TB in 2016 .
It is well known that HIV gradually weakens the immune system, thus increasing the risk of developing TB in people with HIV co-infection. Actually, the risk of developing TB is estimated to be between 16–27 times higher in people living with HIV than among those without HIV infection. In fact, it is estimated that the lifetime risk for HIV negative people to progress from latent to active TB is about 5–10%. Conversely, this same figure is the annual risk for HIV co-infected individuals.