Mycobacterium tuberculosis in persons infected with the human immunodeficiency virus

BACKGROUND: After decades of decreasing incidence, the number of new tuberculosis cases started to rise again in the mid-1980s and continues to be a major public health problem in the United States. The incidence of tuberculosis and drug-resistant tuberculosis is increasing among persons infected with human immunodeficiency virus. OBJECTIVE: To review the epidemiology, pathogenesis, clinical presentation, diagnosis, drug therapy, patients' nonadherence to prescribed treatment, and nursing issues related to the care of persons dually infected with tuberculosis and human immunodeficiency virus. METHODS: Fifty references addressing important issues in tuberculosis and human immunodeficiency virus were identified by searching the Medline data base and bibliographies of relevant articles. DISCUSSION: Tuberculosis is a communicable infectious disease caused by Mycobacterium tuberculosis. It is curable and preventable but generally fatal if undiagnosed and untreated. People with human immunodeficiency virus infection are at higher risk for reactivation of latent tuberculosis infection and for developing life-threatening tuberculosis. Specific nursing interventions are formulated to guide practice when caring for HIV-infected persons with tuberculosis. Future nursing research needs are suggested. CONCLUSIONS: An understanding of the complexity of the care involved will enhance the clinical management of tuberculosis in human immunodeficiency virus-infected patients and lead to a decline in the appearance of new drug-resistant tuberculosis strains.