Multifactorial aspects of tuberculosis and HIV coinfection: challenges and perspectives

Abstract

Objective: To analyze the multifactorial aspects that influence coinfection with Human Immunodeficiency Virus (HIV) and tuberculosis (TB), addressing the biological, social, and structural dimensions involved in its occurrence, as well as the challenges related to diagnosis, the vulnerability of affected populations, and the response capacity of health systems. Literature review: Tuberculosis-HIV (TB-HIV) coinfection is driven by strong social determinants that affect vulnerable populations and hinder adherence and therapeutic success. Structural, educational, and psychosocial barriers exacerbate abandonment and mortality. Outdated guidelines limit progress, and the country remains far from the TB elimination goals. Integration between programs, timely diagnosis, and strengthening adherence are essential to improve care and reduce the burden of coinfection. Final considerations: This paper synthesizes the evidence on TB-HIV coinfection, demonstrating how biological, social, and structural factors combine to increase clinical severity, hinder diagnosis, and compromise treatment. The analysis highlights the main therapeutic and programmatic challenges and reinforces the need for integrated strategies that improve care and reduce morbidity and mortality, thus fulfilling the objective proposed by the study.