5 Myths About Tuberculosis You Need to Know About 

Introduction

About one quarter of the world’s population is thought to be infected with Tuberculosis (TB) and with such a huge group of people, widespread Tuberculosis myths are only to be expected¹. These misconceptions can lead to delayed diagnoses, fear-driven stigma, and poor treatment outcomes.  

In this article, we aim to dispel five of the most common myths associated with tuberculosis, using evidence-based information to promote greater awareness, understanding, and public health literacy.  

Myth 1: “Tuberculosis (TB) Occurs Only in Lower Socioeconomic Groups”

Fact: Tuberculosis can be contracted by anyone, although certain populations, such as people with comorbidities like diabetes, people with reduced immunity, malnourished people, and people who smoke/drink, are at a greater risk². Individuals in contact with these people are also at risk. 

Contrary to the popular myth that Tuberculosis is lifelong, tuberculosis can be cured with the right treatment, although it depends on drug-susceptibility, adherence, and host factors. ATT (Anti tubercular therapy) is a highly effective way to treat this bacterial infection, which is infact available free of cost by Government of INDIA under the NTEP (National TB Elimination Program). The usual treatment for TB involves a combination of several antibiotics, which need to be taken consistently for a minimum of 6 months. 

Myth 2: “If I Don’t Have TB Symptoms, I Don’t Have TB”

Fact: A person can be infected with TB bacteria for years without suffering any ill effects. Perhaps 90 percent of all TB infections remain asymptomatic³. Immunocompromised patients (HIV, immunosuppressive therapy, diabetes, malnutrition) are at higher risk, but not every latent TB infection necessarily reactivates and shows symptoms. 

If patients are not cured or follow inadequate/irregular treatment and their disease becomes resistant, they then must take second-line drugs. These drugs are administered when first-line drugs fail. Treatment for MDR-TB is commonly administered for 2 years or longer and involves daily injections for six months. 

Myth 3: “I Have Been BCG Vaccinated So I Don’t Need to Worry About Getting Infected”

Fact: The BCG vaccine (a weakened live strain of Mycobacterium bovis) is primarily used to protect children from severe forms of TB, such as miliary or meningeal tuberculosis. It may provide variable protection against pulmonary TB in adults, depending on geographic region and exposure, but this protection is not consistent⁴. In the U.S., universal BCG vaccination is not practiced due to the low incidence of TB and potential interference with tuberculin skin testing, though it may be used in select high-risk individuals, such as children with unavoidable exposure or for certain healthcare workers. 

Tuberculosis may also impact the gastrointestinal tract, most common features are fever and abdominal pain that is often relieved by defecation or vomiting. 

Myth 4: “I Cannot Take Antiretrovirals (ARVs) and TB Treatment Together”

Fact: Everyone who is infected with Human Immunodeficiency Virus and has TB has to take ARVs⁵. The timing of ARV initiation depends on the CD4 count and clinical condition^6,7. 

• For CD4 <50 cells/µL: ARVs should be started within 2 weeks of TB treatment. 
• For CD4 ≥50 cells/µL: ARVs should be started within 8 weeks of TB treatment. 
• In patients with low CD4 (<50), waiting 2 weeks may be too long; early ART is preferred. 
• In TB meningitis, ART is delayed (by 4 to 8 weeks) to reduce the risk of life-threatening IRIS. 

Patients with undiagnosed TB who start antiretroviral therapy (ARVs) may develop TB-IRIS (Immune Reconstitution Inflammatory Syndrome), in which the immune system mounts an exaggerated response to existing TB antigens. This can make TB appear clinically worse, but it does not indicate treatment failure. Proper screening for TB in HIV patients before starting ARVs is therefore essential⁸.

Myth 5: “Presence of Tuberculosis Infection in the Lung Predisposes to the Development of Lung Cancer”

While active TB infection does not directly increase the risk of lung cancer, healed TB with residual scarring (scar carcinoma) is associated with a slightly higher risk, particularly for a type of lung carcinoma that is adenocarcinoma, due to chronic scarring and inflammation⁹. Other major risk factors for lung cancer include smoking (cigarettes, cigars, pipes), passive smoke exposure, occupational exposures (asbestos, silica, radon, diesel exhaust), genetic susceptibility, radiation exposure, and chronic lung diseases such as COPD¹⁰. 

Conclusion

By dispelling these five widespread misconceptions, we intend to clarify the reality of tuberculosis (TB). With the correct information and medical attention, TB is preventable, treatable, and curable. The global endeavour to eradicate tuberculosis must include promoting early detection, combating stigma, and raising awareness. Let’s use the truth to strengthen our communities and dispel fear. 

References

1. World Health Organization. Tuberculosis [Internet]. World Health Organization; 2023 Dec 14 [cited 2025 Sep 23]. Available from: https://www.who.int/news-room/fact-sheets/detail/tuberculosis 
2. Trajman A, Campbell JR, Kunor T, Ruslami R, Amanullah F, Behr MA, Menzies D. Tuberculosis. Lancet. 2025 Mar 8;405(10481):850-866. Available from: https://pubmed.ncbi.nlm.nih.gov/40057344/ 
3. Tobin EH, Tristram D. Tuberculosis Overview [Internet]. StatPearls Publishing; [cited 2025 Sep 23]. Available from: https://www.ncbi.nlm.nih.gov/books/NBK441916/ 
4. Ari MM, Beig M, Sholeh M, Khoshmirsafa M. The BCG vaccine, advantages, and disadvantages of introducing new generation vaccines against Mycobacterium tuberculosis. Clin Exp Vaccine Res. 2024 Jul;13(3):184-201. Available from: https://pmc.ncbi.nlm.nih.gov/articles/PMC11319110/ 
5. Abdool Karim SS, Naidoo K, Grobler A, Padayatchi N, Baxter C, Gray AL, Gengiah T, Gengiah S, Naidoo A, Jithoo N, Nair G, El-Sadr WM, Friedland G, Abdool Karim Q. Integration of antiretroviral therapy with tuberculosis treatment. N Engl J Med. 2011 Oct 20;365(16):1492-501. Available from: https://pmc.ncbi.nlm.nih.gov/articles/PMC3233684/ 
6. National Institutes of Health. Tuberculosis/HIV Coinfection [Internet]. U.S. Department of Health and Human Services; [cited 2025 Sep 23]. Available from: https://clinicalinfo.hiv.gov/en/guidelines/hiv-clinical-guidelines-adult-and-adolescent-arv/tuberculosishiv-coinfection 
7. Quinn CM, Poplin V, Kasibante J, Yuquimpo K, Gakuru J, Cresswell FV, Bahr NC. Tuberculosis IRIS: Pathogenesis, Presentation, and Management across the Spectrum of Disease. Life (Basel). 2020 Oct 29;10(11):262. Available from: https://pmc.ncbi.nlm.nih.gov/articles/PMC7693460/ 
8. Lanzafame M, Vento S. Tuberculosis-immune reconstitution inflammatory syndrome. J Clin Tuberc Other Mycobact Dis. 2016 Mar 11;3:6-9. Available from: https://pmc.ncbi.nlm.nih.gov/articles/PMC6850228/ 
9. Cabrera-Sanchez J, Cuba V, Vega V, Van der Stuyft P, Otero L. Lung cancer occurrence after an episode of tuberculosis: a systematic review and meta-analysis. Eur Respir Rev. 2022 Jul 27;31(165):220025. Available from: https://pmc.ncbi.nlm.nih.gov/articles/PMC9724897/ 
10. Schabath MB, Cote ML. Cancer Progress and Priorities: Lung Cancer. Cancer Epidemiol Biomarkers Prev. 2019 Oct;28(10):1563-1579. Available from: https://pmc.ncbi.nlm.nih.gov/articles/PMC6777859/ 

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