istorically, the unprecedented resurgence of tuberculosis (TB) in the nited States (U.S.), peaking in the early 1990s, coincided with the rowing human immunodeficiency virus (HIV) epidemic. Since that ime, with the introduction of highly active antiretroviral therapy HAART) and successful implementation of treatment and infection ontrol measures, the number of patients infected with HIV and TB is eclining in the U.S. However, worldwide rates remain impressively igh with approximately one-third of the 40 million HIV-infected persons o-infected with TB. In 2006, TB still remains a major opportunistic nfection in HIV-infected patients, often the first indication of immunoeficiency. Several important factors associated with HIV have characteristically romoted the spread of TB, including the atypical clinical presentations of B, the reduced sensitivity of the tuberculin skin test (TST) in HIVnfected persons, lack of compliance with and toxicity of chemotherapy, nadequate infection control, and the emergence of drug-resistant strains f Mycobacterium tuberculosis. However, unlike other opportunistic nfections associated with HIV, TB is unique in that it may be readily ransmitted to immunocompetent individuals via the respiratory route, can ccur at any stage of HIV infection, and maintenance therapy is not ecessary after an adequate course of therapy. Physicians should be aware hat the epidemiology, clinical manifestations, and management of uberculosis are altered in HIV-infected patients. HIV testing is recomended for all suspected or confirmed cases of TB.