THE SOUTHERN AFRICAN JOURNAL OF HIV MEDICINE JUNE 2005 23 TUBERCULOSIS Diagnosing HIV-Associated Tuberculosis

‘The world has made defeating AIDS a top priority. This is a blessing. But TB remains ignored. Today we are calling on the world to recognise that we can’t fight AIDS unless we do much more to fight TB as well. ’ Nelson Mandela: Media briefing on ‘Confronting the Joint HIV-TB Epidemics’, co-convened by the Bill & Melinda Gates Foundation, Thursday 15 July 2004. South African health care workers, along with those in other developing countries, are witnessing the disastrous intersection of the HIV and tuberculosis (TB) epidemics. The World Health Organization (WHO) estimates that currently the incidence of TB in South Africa is 536 cases/100 000 annually and that 61% of patients diagnosed with TB are HIV-infected.1 TB is the commonest HIV-associated opportunistic infection and one of the leading causes of AIDS-related death.2-4 Ironically, HIV infection is easy to diagnose with highly accurate serological tests but cannot be cured, and TB can often be difficult to diagnose but is curable with freely available and highly effective antituberculosis therapy. There is a pressing need to develo