Tuberculosis and HIV infection: epidemiology, pathogenesis, and clinical aspects.

Human immunodeficiency virus infection has profoundly affected the epidemiology, natural history, and clinical presentation of TB. It has also contributed in part to the recent epidemic of MDR-TB in the US and significantly reduced the sensitivity (but not the specificity) of the tuberculin skin test. Further research is needed to determine the optimal strategy for chemoprophylaxis in HIV-infected individuals, new methods of diagnosing TB infection and disease, and new drugs to control MDR-TB. Most importantly, however, further funding is necessary to improve compliance with therapy and chemoprophylaxis in order to regain control of this ancient scourge.