A patient with both tuberculosis and HIV may be difficult to diagnose and to treat. A number of possible problems should be borne in mind when handling these patients.
Barriers to diagnosis:
(1) asymptomatic or subclinical illness with nonspecific complaints
(2) negative sputum smears
(3) normal or near normal chest X-ray
(4) poor level of healthcare
Barriers to treatment:
(1) poor compliance due to number of pills being taken
(2) poor compliance following immune reactivation or with adverse drug reactions
(3) multi-drug resistant tuberculosis
(4) advanced immunodeficiency
A patient with one or more barriers may encounter more complications during the course of the illness.
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