Human immunodeficiency virus and osteoarticular tuberculosis.

The human immunodeficiency virus pandemic has contributed to a marked increase in patients infected with tuberculosis. In parts of SubSaharan Africa, osteoarticular tuberculosis has increased fourfold in the past decade and approximately 60% of the patients are infected with the human immunodeficiency virus. The human immunodeficiency virus has complicated the diagnostic process and treatment. Tuberculosis will respond to chemotherapy in patients who are positive for the human immunodeficiency virus but adverse drug reactions are common. Careful assessment is necessary if surgery is contemplated because of the high risk of infection and poor wound healing in patients with advanced human immunodeficiency virus disease. In patients with osteoarticular tuberculosis who are positive for human immunodeficiency virus, the prognosis will depend on the stage that the human immunodeficiency virus infection has reached by the time of presentation.