[Aids].

The number of cases with tuberculosis and human immunodeficiency virus infection is increasing in Japan. Tuberculosis is more likely to cause disease at an earlier stage of immunodeficiency, because M. tuberculosis is more virulent than other HIV-associated pathogens. Reactivation of latent infection has been traditionally considered the most important mechanism in the pathogenesis of active tuberculosis. However, recent exogenous infection may be higher among HIV-infected persons. The most striking clinical feature of tuberculosis in patients with HIV infection is the extremely high frequency of extrapulmonary involvement, usually with concomitant pulmonary tuberculosis. Among severely immunosuppressed patients with HIV infection, chest roentgenogram findings are hilar adenopathy, pleural effusions, and a miliary pattern. Antituberculosis therapy is effective in most patients with HIV infection.