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National Center for HIV, STD and TB Prevention Divisions of HIV/AIDS Prevention |
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, tiny,
moist drops that contain TB germs are sent into
the air. A person who breathes air that contains
these drops 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 working 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
normally 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:
pain in the chest
coughing up blood or phlegm from deep inside the lungs
weakness or fatigueDoes TB affect only the lungs?
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 like TB. Since I have HIV, should I be tested for TB?
Yes. If you have not already had TB or if you
had 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 (called
tuberculin) 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
old. If I have latent TB, can drugs help prevent it from becoming active TB?
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
peripheral neuropathy
(a disorder of the
nervous system).
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 12 months of treatment with
isoniazid to prevent active TB. You need to take
your medicine for the full 12 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 after the first 3 months of your pregnancy.
The germs that caused your latent TB might not
be killed by isoniazid. In that case, you will be
given another drug (probably rifampin) that is
used to prevent TB. If I have active TB, can it be cured?
Yes. The drugs that fight TB work as well as in
people with HIV as they do in people who do not
have HIV.
Several drugs are
used to treat active
TB. You will need to
take more than one
drug for several
weeks. 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 disease. 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
States.
When several different drugs can’t kill TB germs,
the TB is called "multidrug-resistant" TB (MDR
TB). A patient with MDR 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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