- Tuberculosis (TB) is caused by a germ
called Mycobacterium tuberculosis.
- TB is spread through the air. You need to have close contact with a person who has
TB to get it.
- Get tested for TB as soon as possible after learning you have HIV. Go to your doctor or your health department for a skin test
- You can take medicines to prevent and to treat TB.
What is tuberculosis?
Tuberculosis (TB) is a disease caused by a germ
called Mycobacterium (my-ko-bak-TEER-I-um)
tuberculosis. TB most often affects the lungs,
but TB germs can infect any part of the body.
TB may be latent or active TB. “Latent” means
that the germs are in the person’s body but are
not causing illness. If you have latent TB you will
not have symptoms and cannot spread TB.
However, if HIV has made your immune system
too weak to stop the TB germs from growing,
they can multiply and cause active TB (also
called TB disease).
In people with HIV, TB in the lungs or anywhere
else in the body is called an AIDS-defining
condition. In other words, a person with both
HIV and active TB has AIDS.
How is TB spread?
TB is spread from one person to another through
the air. When a person who has TB disease of
the lung or throat coughs, sneezes, or sings, TB germs may be sent into
the air. A person who breathes air that contains
these germs may get TB. People with TB disease
are most likely to spread it to people they spend
time with every day, such as family members,
friends, or coworkers.
You can’t get TB from shaking hands, sitting on
a toilet seat, or sharing dishes or utensils.
How can I avoid TB?
Some activities and jobs may increase your
chances of spending time with people who
have TB and getting TB. These include working
in a health care setting
(a hospital, a clinic, a doctor’s office),
in jails and prisons, and in shelters for homeless
people. You and your doctor should decide
whether you should be working in such a place. If
you do things that may increase your chances of
getting TB, you and your doctor may decide that
you need to be tested for TB more often than
once a year.
If you can, avoid spending time with someone
who has active TB but is not taking medicine or
has just started taking medicine. A person who
has been taking medicine for a few weeks can
usually no longer spread TB to you.
That person’s doctor will say when it’s safe for
other people to spend time with him or her.
If you are exposed to a person with active TB,
you should ask your doctor about getting treatment,
even if your skin test was negative for TB.
How do I know if I might have active TB?
Your symptoms depend on where in your body the TB germs are growing.
TB germs usually grow in the lungs. TB in the lungs may cause:
- a bad cough that lasts longer than 3 weeks
- pain in the chest
- coughing up blood or phlegm from deep inside the lungs
Other symptoms are:
- weakness or fatigue
- weight loss
- no appetite
- sweating at night
Does TB affect only the lungs?
No. Active TB most often
affects the lungs.
But it can
also affect almost any other
organ, such as the
kidneys or the spine.
A person whose TB is not in
the lungs or
cannot give TB to other
Am I at greater risk of getting TB because I have HIV?
Yes. Latent TB is much more likely to become
active TB in someone with HIV. This is because
HIV weakens the immune system, which makes
it harder for the body to fight off diseases
Since I have HIV, should I be
tested for TB?
Yes. If you have not already had TB or a positive result from a skin test for TB in the
past, get a tuberculin skin test, or TST at the
health department or your doctor’s office.
When you have the test, a health care worker
will inject a small amount of testing fluid just under the skin on the lower part
of your arm. After 2 or 3 days, the health care
worker will check your arm to see whether you
had a positive reaction to the test.
If you have a positive test result (which usually
means you have latent TB), you may need other
tests to see whether you have TB disease (active
TB). These tests usually include a chest x-ray
and a test of the phlegm you cough up.
Because TB can grow somewhere else in your
body, other tests may be done.
If you have a negative test result you should be
tested again at least once a year, depending on
your chances of getting TB. Discuss your
chances of getting TB with your doctor.
If you are an HIV-infected mother whose baby
was born after you got HIV, have your baby
tested for TB when the baby is 9 to 12 months
If I have latent TB, can drugs
help prevent it from becoming
Yes. The drug isoniazid can help prevent latent
TB from becoming
active TB. People
with HIV infection
who need to take
isoniazid are also
given a vitamin called
pyridoxine to prevent
(a disorder of the
Get tested for latent
TB, with a TST, as
soon as possible after
you learn you have HIV. If your skin test result is
positive (but you do not have active TB), you will
most likely be given 9 months of treatment with isoniazid to prevent active TB. You need to take
your medicine for the full 9 months because TB
germs die very slowly. Take your medicine exactly
as your doctor or nurse tells you.
If you are a woman who is pregnant, you may
still take isoniazid to fight TB. However, your
doctor may tell you not to take the medicine
until 3 months after delivery.
The germs that caused your latent TB might not
be killed by isoniazid. In that case, you will be
given another drug (probably rifampin) or a combination of drugs
used to prevent TB.
If I have active TB, can it be
Yes. The drugs that fight TB work as well in
people with HIV as they do in people who do not
Several drugs are
used to treat active
TB. You will need to
take more than one
drug for several
months. Your symptoms may go away
within a few weeks
after you start taking
the medicine. TB
germs die very
slowly, so you need
to keep taking your
medicine exactly as your doctor or nurse tells you
(the right amount at the right time for the right
length of time).
Can I give TB to other people?
Yes. If you have TB disease of the lungs or
throat, you can probably spread TB to other
people. You may need to stay home from work
or school or other activities for a few weeks.
After you’ve taken your medicine for a few
weeks, you will probably no longer be able to
spread TB to others, but you need to continue
taking your medicine for 6 to 9 months to be
totally cured. Your doctor or nurse will tell you
when you can return to work or school or other
activities. The medicine should not affect your
strength, your sexual function, or your ability to
work. Taking the medicine as prescribed will
keep you from again becoming sick with TB
I am taking protease inhibitors
to fight HIV infection. Can I
also take medicine to cure TB?
Yes. But you should know that medicines for TB
and the protease inhibitors affect each other.
Your doctor will decide which combination of
medicines will work best for you.
What is drug-resistant TB?
When TB germs are not killed by a certain drug,
that TB is called "drug-resistant." TB germs
may become resistant when patients do not take
their medicine long enough or in the right
amount at the right times. Follow your doctor’s
advice when taking medicines.
People who have drug-resistant TB can transmit
it to others. Drug-resistant TB is found often in
people who come from areas where TB is common
(for example, Africa, Southeast Asia, Latin
America) but it also occurs in parts of the United
When at least two of the best anti-TB drugs (isoniazid and rifampin) can’t kill
TB germs, the TB is called "multidrug-resistant" TB (MDR TB). A more serious
form of MDR TB—“extensively drug resistant TB” (XDR TB)—is a relatively rare
type of TB that is resistant to nearly all of the most effective medicines used
to treat TB. A patient with MDR or XDR TB may need to see a doctor who is an
expert on drug-resistant TB and who can recommend the best combination of drugs
to fight the germs.
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