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Despite being preventable and curable, Tuberculosis is the leading cause of HIV-associated mortality, accounting for one of every five HIV-related deaths. The risk of developing TB is 30 times higher among people living with HIV than among people who do not have HIV infection.

TB/HIV Coinfection Regional Clinical Manual. 2017 Update


Independent of their HIV status, key populations, in particular people who inject drugs and prisoners, have an increased risk of TB, including multidrug-resistant TB (MDR-TB). In addition, outbreaks of TB and MDR-TB have been reported among men who have sex with men and transgender sex workers. Common risk factors and social determinants that put key populations at increased risk of TB include HIV infection, poverty, malnutrition, stress, alcoholism, smoking, diabetes, indoor air pollution, drug use, incarceration and poor living and working conditions.

Key facts:

As of 2017, in the Americas, WHO estimated:

  • 228,943 new cases of tuberculosis
  • 30,000 new cases of TB associated with HIV (11%)
  • 24,000 deaths in people with TB, 25% of whom are coinfected with HIV
  • Among the cases tested for HIV, 8.9% presented TB/HIV co-infection



Routine HIV testing should be offered to all people with presumptive and diagnosed TB (strong recommendation, low quality of evidence)

ART should be initiated in all individuals with HIV and active TB disease regardless of WHO clinical stage or CD4 cell count (strong recommendation, low quality of evidence)


PAHO Health Topic