Impact of HIV Infection on Mycobacterial Disease

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The current epidemic of human immunodeficiency virus (HIV) infection and acquired immunodeficiency syndrome has resulted in a worldwide resurgence of tuberculosis. In the United States, the number of new cases of tuberculosis has increased in the past five years, leading to a cumulative excess of about 15,000 cases. The clinical and epidemiologic picture of tuberculosis in AIDS patients differs drastically from the standard presentation of tuberculosis cases in HIV-negative patients. The diagnosis and management of tuberculosis, particularly atypical mycobacterial infections, present a challenge in HIV- infected patients. Prevention of the transmission of disease is a major concern. Since atypical mycobacterial infection and disease pose a greater management challenge, this article summarizes diagnosis and treatment of atypical mycobacterial infection in HIV-positive patients.