Based on the indirect evidence of protective immune responses against aTB induced by HBHA in humans and on direct evidence in animal models, we propose that HBHA-IGRA+QFT- patients should not be prioritized to receive anti-TB prophylaxis before anti-TNF-α treatment, but that the persistence of their protective anti-HBHA immune response during treatment should be controlled. This evidence concerns the gene TNF and tuberculosis.