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RATIONALE Recently defined transcriptional signatures distinguish active from latent tuberculosis (LTBI) but a signature that predicts progression to active disease has not been defined. Comparison of the transcriptional profile at the earliest, subclinical stages of reactivation (of which HIV-1 co-infection is a cause) may identify elements of the active tuberculosis (TB) signature detectable initially, and thereby facilitate the development of predictive diagnostic tests and provide biological insight into reactivation and disease progression. METHODS