8.2.6
TB
Clinical HIV Guidelines, 5th Edition, 2022. Chapter 8, HIV-related diseases.
Signs and symptoms
Very variable depending on organs affected. Persistent fever / drenching night sweats; weight loss; failure to thrive; cough; anaemia <8g/dl; enlarged nodes; meningitis signs
Investigations
Clinical exam and history Often difficult to confirm in PLHIV. Clinical diagnosis is critical, particularly in children with possible TB signs/symptoms and TB contact, even if investigations are not clear.
Xpert MTB-RIF 2x sputum Also consider: ascites, CSF, lymph gland material, pleural or pericardial fluid CXR Microscopy Fine needle aspiration of lymph nodes; CSF Biochemistry Pleural tap: straw coloured effusion? CSF Urine LAM See section 8.1on page 22 Focused Assessment with Sonography for HIV associated tuberculosis (FASH)
Test for COVID-19 Primary and secondary management See National TB guidelines
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