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The co-infection of HIV and tuberculosis (TB) is a significant public health challenge in Brazil and worldwide, as both diseases disproportionately affect vulnerable populations. HIV, which compromises the immune system, drastically increases the likelihood of developing active TB. It is estimated that individuals with HIV are 21 to 34 times more likely to contract TB than those without the virus, making TB the leading cause of death among people living with HIV/AIDS. In Brazil, over 300,000 new HIV cases were reported between 2007 and 2019, with a prevalence among adults aged 25 to 39. HIV/TB co-infection is associated with social factors such as poverty, low educational levels, and limited access to information and healthcare services, often leading to late diagnosis and treatment discontinuation. This is particularly common among key populations, including men who have sex with men, sex workers, transgender individuals, and drug users. Early diagnosis of TB in people with HIV is challenging due to altered clinical symptoms and lower sensitivity in bacilloscopy tests. However, integrated treatment for HIV and TB is effective, though it requires high adherence to complex therapeutic regimens. Antiretroviral therapy (ART) should be initiated in all patients with active TB, regardless of CD4 lymphocyte count, and combined with TB treatment. In addition to physical challenges, co-infection generates emotional and social impacts, such as stigma and family rejection, which hinder treatment adherence. Therefore, it is essential to improve screening and treatment policies for these infections and provide psychological support integrated with clinical care, aiming to increase adherence and reduce associated mortality.
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