The manifestations of TB vary with the stage of HIV infection. When cell-mediated immunity is only partly compromised, pulmonary TB presents as typical upper-lobe cavitary disease. In late HIV infection, a primary TB-like pattern may be evident, with diffuse interstitial or miliary infiltrates, little or no cavitation, and intrathoracic lymphadenopathy.

• Extrapulmonary disease occurs frequently; common forms include lymphadenitis, meningitis, pleuritis, pericarditis, mycobacteremia, and disseminated disease.
• Immune reconstitution inflammatory syndrome (IRIS), which may occur 1-3 months after initiation of antiretroviral therapy, may exacerbate the signs and symptoms of TB.