HIV/TB co-infection presents a significant public health challenge due to the synergistic interaction between the twopathogens. HIV weakens the immune system, making individuals more susceptible to TB infection and reactivationof latent TB. Conversely, active TB accelerates the progression of HIV to AIDS by further compromising immunefunction, increasing viral replication, and promoting viral mutation. This interaction not only worsens clinical outcomesbut also increases mortality rates among people living with HIV (PLWH). The mutual enhancement of these pathogensmeans that HIV infection increases the likelihood of TB infection and reactivation due to the compromised immunesystem. TB infection, in turn, accelerates the deterioration of immune function in PLWH, leading to faster progressionto AIDS. Active TB is a leading cause of death among PLWH. In 2019, approximately 33% of the 690,000 AIDS-related deaths were attributable to HIV-associated TB.

Diagnosing TB in HIV-coinfected individuals is particularly challenging due to the reduced sensitivity of conventionaldiagnostic methods like sputum smear, sputum culture, tuberculin skin tests, and interferon-gamma release assays. Thelower immune response in PLWH leads to lower detection rates with these methods. Emerging diagnostic approaches,such as micro RNAs, soluble inflammatory markers, and proteomic analysis, show promise for early detection of TBin HIV-coinfected individuals. However, these methods require further research and validation. Strengthening theintegration of HIV and TB control programs can reduce diagnostic delays, improve early case detection, ensure prompttreatment initiation, and ultimately reduce transmission rates. This integration is crucial for managing co-infectionand improving patient outcomes. To address these challenges, health systems need to focus on enhancing screeningand diagnostic methods, developing and validating new diagnostic tools that are effective in immunocompromisedindividuals, and implementing coordinated care strategies that address both HIV and TB simultaneously.