TB in HIV-positive individuals has a different mode of presentation, and may go undetected for some time. It occurs mainly in young individuals, manifests minimal caseation, plenty of AFB’s (acid fast bacilli) often extra-cellular, and in 50% of cases, another organ than the lung is primarily affected. A negative tuberculin test, the presence of bilateral hilar lymph-adenopathy, the lack of cavitation, the presence of diffuse lung infiltrates, and / or an extra-pulmonary localization may contribute to delay in diagnosis, especially in cases where the HIV-status is not yet known.

TB R/ should include an initiation phase of 3-4 mo. with INH, RMP, PZA, EMB and a consolidation phase of 6-9 mo. with INH and RMP.

If necessary, DOT should be applied.