TB still much more common in people with HIV in high-income settings
TB prevalence, illness and deaths are very much more common in the low- and middle-income countries than high-income countries. However the higher rate of TB in low- and middle-income settings, especially in people with HIV, has meant that large TB studies have tended to be conducted there, and in some ways we know less about TB in high-income settings, especially in people with HIV.
People diagnosed with HIV in high-income countries, especially if they do not come from areas with high HIV and/or high TB prevalence, are less systematically tested for TB and so won’t get the opportunity to take TB prevention drugs if they have latent TB. In addition, we also don’t know the extent to which antiretroviral treatment for people with HIV and latent TB lowers the risk of developing active TB so as to make TB prevention therapy unnecessary.
