Unformatted text preview: Tuberculosis 3. TB and HIV TB in the USA declined steadily from the 1930s until the mid-1980s (because of public health measures and rising living standards, as well as anti-TB drugs), but then began to rise, because of the HIV epidemic and misguided public health budget-cutting. TB resistant to multiple drugs also appeared. Because of increased public health measures (including “directly-observed therapy” for TB) the disease is falling again. Whereas the incidence of active TB in immunocompetent infected patients is about 4-8% over a lifetime, that in HIV patients is about 8% per year! Because it is a virulent infection, TB often affects patients with HIV early in their HIV disease (unlike true opportunistic infections which present when the CD4 count has dwindled). Moreover, TB in HIV-infected patients often presents in extrapulmonary locations. 4. “Atypical” mycobacterial infections There are numerous “atypical” mycobacterial species. In contrast to M. tuberculosis, they arise There are numerous “atypical” mycobacterial species....
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- Fall '10