Therefore, our findings suggest a significant improvement over the Alere LAM test in both HIV-positive patients with higher CD4+ T-cell counts (difference 59%, 95%CI 32% to 75%, p = 0.0009) but more importantly in HIV-negative individuals with tuberculosis (difference 49%, 95%CI 37% to 59%, p<0.0001), two key patient populations that are not adequately covered by the Alere LAM test. This evidence concerns the gene CD4 and tuberculosis.