While TNFα antagonists have the potential to improve TB therapy when used as adjunctive agents, there have been concerns about their expense, their need to be given parenterally, and the potential for disease worsening if administered without adequate anti-TB chemotherapy, and due to these concerns advanced clinical trials to test them as adjunctive HDTs for TB have not been performed (18, 60, 67). This evidence concerns the gene TNF and tuberculosis.