Hi, I'm writing because I've been on/off HIV meds since 2003, for various reasons. I have been on meds long-term now for over a year, and my cd4 has improved from 1% to 11%, and viral load undetected. Well, about 5 months ago I was diagnosed with TB, and am on the combo therapy for that as well. Is it possible that having such a compromised immune system, the TB could become re-active later if my immune system becomes weaker? My chest x-rays show nodules and calcification from TB infection. I'm not on the strongest TB dosage because it interacts with the Norvir I'm taking. I take Norvir, Prezista, and Truvada and the 5-pill combo for TB. Thanks for your help.

Hello.

TB/HIV coinfection is a common and often challenging problem. HIV weakens the immune system, increasing the likelihood of opportunistic infections. TB can increase the rate of HIV replication, which can lead to decreased CD4 and worsening of HIV/AIDS. Both infections need to be treated aggressively by a knowledgeable physician. I'll post below a link to some information about TB/HIV coinfection.

I should also mention that all folks with TB/HIV coinfection should receive trimethoprim/sulfa prophylaxis against pneumocystis and toxoplasmosis.

Good luck.

Dr. Bob

Tuberculosis (TB)From AIDS InfoNet May 17, 2011

Tuberculosis and HIV Disease From Project Inform November 2004