HIV/AIDS in India: Which opportunistic infection is the most common co-infection among people living with AIDS in India?

Introduction / Context:
Understanding regional epidemiology is critical for clinical decision-making. In India and many high-burden countries, tuberculosis (TB) is the most frequent opportunistic infection (OI) among people with HIV/AIDS, driving morbidity and mortality.

Given Data / Assumptions:

• Setting: India, where TB prevalence is high.
• Population: AIDS patients with immunosuppression.
• We need the most common OI, not rare presentations.

Concept / Approach:
HIV-induced CD4+ T-cell depletion increases risk of reactivation and progressive primary TB. TB can present at any CD4 count and is often the sentinel AIDS-defining illness in endemic settings. Other OIs exist but are less prevalent overall than TB in India.

Step-by-Step Solution:
List common OIs in India: TB, candidiasis, cryptococcosis, PCP, toxoplasmosis, cryptosporidiosis. Weigh prevalence data: TB is consistently the most common co-infection. Select “Tuberculosis” as the best single answer.

Verification / Alternative check:
National program data and hospital cohorts show high TB–HIV coinfection rates; TB screening is integrated into HIV care (and vice versa) due to this burden.

Why Other Options Are Wrong:
Cryptosporidiosis/toxoplasmosis/cryptococcosis occur but are less common than TB overall in India; “PCP only” ignores broader epidemiology.

Common Pitfalls:
Transferring Western OI patterns (e.g., PCP predominance) to Indian settings; always consider local prevalence.

Final Answer:
Tuberculosis.