Tuberculosis and mycobacterioses in the AIDS era
Chrétien, J.; Papillon, F.
La Revue du Praticien 40(8): 709-714
1990
ISSN/ISBN: 0035-2640 PMID: 2320894 Document Number: 351555
The emergence of the HIV infection has been concomitant with a halt, noticed as early as 1986, in the regression of tuberculosis. The resurgence of tuberculosis, and indeed of all mycobacterioses, is determined by the HIV-induced alteration of cell-mediated immunity, which encourages the development of tuberculous and non-tuberculous bacteria. These bacteria themselves have an immunosuppressant effect on CD4 lymphocytes and macrophages, thus contributing to the progress of the HIV infection. The HIV and tuberculous infections therefore constitute a kind of "diabolical duo", the degree of endemia of one of these two diseases being influenced by the other and reciprocally. The final result is a menace to all countries where tuberculosis is strongly endemic and where the HIV infection is spreading. Only one of these infections, tuberculosis, is within the reach of our therapeutic armentarium. Patients must be investigated for tuberculosis systematically and actively--even though this disease may be hidden by misleading clinical signs and symptoms of AIDS--in order to treat it and separate, at least partially, the diabolical duettists.