21.4.4 Pulmonary tuberculosis (PTB)
Pulmonary tuberculosis (PTB), that is, TB in the lungs, is extremely common in PLHIV. Remember from Study Session 13 that you should suspect pulmonary TB if a patient has a chronic cough for more than two weeks, whitish sputum, fever or sweating (often at night), loss of appetite, weight loss, and sometimes chest pain or spitting up blood. The presence of pulmonary TB in a person living with HIV indicates WHO HIV clinical stage 3. Note that extra-pulmonary TB (outside the lungs) is indicative of WHO clinical stage 4, and requires an urgent referral.