Modern Approaches to the Diagnosis, Prevention, and Management of Tuberculosis in People Living with Human Immunodeficiency Virus Infection

Abstract

Tuberculosis and human immunodeficiency virus infection remain among the leading causes of infectious morbidity and mortality worldwide. The coexistence of these diseases is associated with a markedly increased risk of developing active tuberculosis, difficulties in timely diagnosis, the emergence of drug-resistant Mycobacterium tuberculosis, and considerable challenges in patient management, highlighting the need to improve current approaches to diagnosis, prevention, and treatment. Objective of the study: to summarize current scientific evidence regarding the epidemiology, pathogenesis, modern diagnostic methods, prevention, and treatment of tuberculosis in people living with human immunodeficiency virus infection. A comprehensive review of contemporary scientific publications and World Health Organization recommendations addressing the epidemiology, diagnosis, prevention, and management of tuberculosis in people living with human immunodeficiency virus infection was conducted. The analysis of current evidence demonstrated that human immunodeficiency virus infection substantially increases the risk of active tuberculosis through progressive impairment of cellular immune responses, whereas tuberculosis accelerates the progression of immunodeficiency. The highest diagnostic accuracy is achieved through the combined use of clinical screening, radiological examination, molecular diagnostic techniques, and bacteriological methods. Timely identification of latent tuberculosis infection and the initiation of preventive treatment after exclusion of active tuberculosis significantly reduce the incidence of active disease and tuberculosis-related mortality. Short-course rifamycin-containing preventive regimens have demonstrated high effectiveness and improved treatment adherence. Effective patient management requires an individualized therapeutic approach that considers clinically significant drug interactions between antituberculosis and antiretroviral medications. The synthesis of current evidence supports the implementation of comprehensive diagnostic algorithms, systematic screening for latent tuberculosis infection, timely preventive treatment, and individualized therapeutic strategies. These approaches may improve the quality of healthcare, optimize patient management, enhance treatment outcomes, and reduce mortality among people living with human immunodeficiency virus infection.