Assessment and management of persons coinfected with tuberculosis and human immunodeficiency virus.

After eight decades of decline, cases of tuberculosis (TB) have increased substantially since 1985. This increase is attributed largely to a reactivation of disease in persons who are coinfected with TB and human immunodeficiency virus (HIV). Multiple-drug resistant tuberculosis (MDR-TB) has a high mortality rate (70 to 90%), mostly occurring in individuals with HIV. Death often results within 4 to 16 weeks of diagnosis. The pathogenesis, screening, chemoprophylaxis, diagnosis, and treatment of persons coinfected TB and HIV is reviewed. Attention is given to infection control and occupational exposure. A chart of commonly prescribed antituberculosis medications is listed, including recommended adult dosages, side effects, and drug interactions. Clinicians must incorporate meticulous TB screening and treatment for all patients coinfected with HIV and TB.