Background:

Pulmonary tuberculosis (PTB) is a world public health problem. Its association with human immunodeficiency virus (HIV) occurs as a consequence of immunosuppression that facilitates coinfection.

Materials and methods:

A descriptive observational study of consecutive cases from January 6 to September 30, 2016, was made in a tertiary care reference center in Mexico, where HIV-positive patients suspicious of having PTB were negative for bacilli in the acid-fast stain of sputum. Bronchial lavage (BL) was performed and cultures for Mycobacterium tuberculosis (Mtb) were made to confirm PTB. Some cases were tested with Xpert® MTB/RIF® methodology with a polymerase chain reaction to detect Mtb and its sensitivity to rifampicin.

Results:

BL was performed on 82 HIV-positive acid-fast negative patients from whom samples were obtained to search for Mtb through culture. Expectoration smear samples of 26 patients resulted in 21 negatives for Mtb. The remaining five patients turned Ziehl-Neelsen positive as well as positive for Mtb through culture. In the 56 cases of non-expectoration and dry cough, 37 patients were negative for Mtb, seven were positive by culture, and 12 were positive by Xpert. A total of 24 (29.2%) cases were positive for Mtb.

Conclusions:

BL facilitates the early diagnosis of PTB in smear-negative HIV-positive patients. Xpert MTB/RIF positive results allowed treatment initiation within 2 h.

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