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British Medical Bulletin Advance Access originally published online on April 30, 2007
British Medical Bulletin 2007 81-82(1):149-165; doi:10.1093/bmb/ldm009
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© The Author 2007. Published by Oxford University Press. All rights reserved. For permissions, please e-mail: journals.permissions@oxfordjournals.org

Diagnosing tuberculosis in HIV-infected patients: challenges and future prospects

Marc Mendelson*

Institute of Infectious Diseases and Molecular Medicine, University of Cape Town, South Africa

* Correspondence to: Marc Mendelson, Institute of Infectious Diseases and Molecular Medicine, Room S2.16, Wernher Beit South Building, Anzio Road, Observatory 7925, Cape Town, South Africa. E-mail: mmendels{at}curie.uct.ac.za

Introduction: The lack of an effective diagnostic test for smear-negative tuberculosis (TB) is a major contributor to the death of HIV patients in countries with high burden of HIV/Mycobacterium tuberculosis co-infection.

The problem: The prolonged incubation time of traditional culture techniques delays time to diagnosis and instigation of effective antituberculous therapy in those who are smear negative. In addition, the increased prevalence of extrapulmonary TB in HIV patients presents a particular diagnostic challenge in resource-poor settings

Discussion: This review highlights the challenges of diagnosing TB in patients with HIV and the recent advances in development of commonly used and novel diagnostic tests for TB.

Keywords: Tuberculosis HIV diagnosis

Accepted for publication March 9, 2007.


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