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

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.