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Bacterial infections: bone and joint tuberculosis.

In many countries of the world, there is now a dual epidemic of tuberculosis and HIV disease. HIV specifically eliminates the tissue macrophages and CD4 lymphocytes, the very cells that provide immunity against tuberculosis. Tuberculosis is one of the more virulent opportunistic infections and it therefore appears fairly early in HIV disease. For the same reasons, bone and joint tuberculosis is becoming much more common. The disturbances of the lymphocyte count, ESR and antigen skin tests associated with HIV, now often make tuberculosis difficult to distinguish from other inflammatory lesions.