Bioengineer.org | As immunity falls, TB in HIV wears a different face on the chest X-ray

Pulmonary TB has long been described as a disease with a signature: a cavity carved into the upper lobes of the lung, surrounded by consolidation, in a patient with a productive cough. But in people whose immune systems have been devastated by HIV, that signature can vanish. A new cross-sectional study from southern Vietnam, published in BMC Infectious Diseases, provides one of the most granular real-world pictures yet of how TB actually looks, sounds and tests in adults with advanced HIV disease, and it confirms a clinical suspicion that has circulated for decades: as CD4 cell counts fall, TB stops looking like TB.

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