Last month we reported the success of the MTB/RIF test in identifying tuberculosis when smears are negative, which occurs ~40% of the time in TB-HIV coinfection. Shah et al publish their success with the sputum MODS assay in an all-HIV clinic in South Africa. The MODS is a rapid (~7-day) culture that also identifies multi-drug resistant TB. The test was 85% sensitive and 97% specific overall, and was 72% sensitive when smears were negative. (Sputum culture was the gold standard.) AJRCCM 2011;183:1427-1433.