Questions: A 37-year-old cisgender woman with HIV has a positive tuberculin skin test. She has no history of receiving treatment for tuberculosis and is currently asymptomatic. What is the approximate risk of progression from latent tuberculosis infection to active tuberculosis disease among people with HIV? 41 to 55% per year 24 to 39% per year 1 to 2% risk per year 3 to 16% risk per year

The answer is the fourth one: 3 to 16% risk per year.

Explanation for each option:

1. 41 to 55% per year: This risk level is too high for the progression from latent tuberculosis infection to active tuberculosis disease, even among people with HIV. Such a high percentage would imply that nearly half of the individuals with latent TB and HIV would develop active TB each year, which is not supported by epidemiological data.

2. 24 to 39% per year: This option also suggests a very high risk, which is not consistent with the known data. While people with HIV do have an increased risk compared to the general population, it is not this high on an annual basis.

3. 1 to 2% risk per year: This risk level is more typical for the general population without HIV. People with HIV have a higher risk due to their compromised immune systems.

4. 3 to 16% risk per year: This range is consistent with the increased risk of progression from latent TB to active TB in individuals with HIV. The risk is significantly higher than in the general population due to the immunosuppressive effects of HIV, which makes this option the most accurate.

In summary, individuals with HIV have a higher risk of progressing from latent TB infection to active TB disease, and the risk is approximately 3 to 16% per year.