Additionally, the overall level of HLA-DR, CD-38, and Ki-67 expression on PPD-specific dual IFN-γ + TNF-α + CD4 + Tcells from smear-positive pulmonary TB patients were higher compared with smear-negative pulmonary TB, confirmed non-TB respiratory disease, apparently healthy QFT positive and negative study participants (p-value = 0.0127, p-value = 0.0001, p-value = p-value < 0.0001, p-value < 0.0001, respectively). Here, CD4 is linked to pulmonary tuberculosis.