ABSTRACT
Introduction Since the beginning of recorded human history, tuberculosis (TB) has always been with us, causing great epidemic plagues during the last millennium that, over the centuries, resulted in more illness and death than those caused by any other infectious disease. Although always simmering away at high endemic levels in the poorer regions of the world, it seemed to us here in the industrially developed world that, by the mid-1900s, TB was coming under control. During the last century, a more complete understanding of the bacterial cause and natural history of TB facilitated the development of effective vaccines, infection control strategies and curative chemotherapy. But then no one reckoned on AIDS . . . HIV came along and gave fresh breath to TB, setting fire to a smouldering global endemic potential and, within just a decade or so, TB once again became a worldwide health emergency, becoming the most common opportunistic disease associated with AIDS. As the global pandemic of HIV disease rapidly escalated, TB became out of control in many countries and the world confronted the spectre of this deadly partnership, TB and HIV infection, working in synergy to threaten the health and life of millions of people.
