Despite diagnosis and treatment, patients with HIV and tuberculosis still die.143 It is important that as many such patients as feasible are examined by autopsy after death. This categorises the causes of death and enables audit of medical practice. The significant categories of pathology include:
If the interval between TB culture positivity and death is <=3 months, culture of tuberculous autopsy tissue should be performed to evaluate drug sensitivity and bacterial viability
Autopsies are either requested by clinicians or (in UK) commanded by a Coroner or Procurator Fiscal. If the autopsy is coronial, every endeavour should be made to obtain the autopsy report for clinical audit. Before any autopsy, contact with the appointed pathologist to discuss the clinico-pathological issues is recommended. Pathology staff should adopt suitableuniversal infection control precautions against airborne and blood borne pathogens