Who is at risk of acquiring tuberculosis?

In the United States, the incidence of tuberculosis was decreasing until 1985 when it reached its nadir. Since 1985, the incidence of tuberculosis has markedly increased. Crowded urban environments, immigration, poverty, homelessness, intravenous drug abuse, loss of tuberculosis control programs, increased use of immunosuppressive medications (e.g., TNF-α inhibitors), and, most importantly, the HIV epidemic account for the rising incidence. High-risk groups include the elderly, urban homeless, alcoholics, intravenous drug abusers, prison inmates, migrant farm workers, minorities, and immunosuppressed patients (with HIV or from iatrogenic causes).