A twenty-year-old female prostitute had an indeterminant HIV western blot in Djibouti during June 1988. She was hospitalised at the tuberculosis hospital in October and was re-tested for HIV in November. Her western blot result was still indeterminant, despite a progressive profile, and she therefore escaped to the hospital's HIV surveillance system. There were strong indications that while in-hospital, the patient resumed the activities of her previous profession. We conclude that active tuberculosis may develop in African HIV patients prior to the development of a confirmatory HIV western blot profile. Thorough precautionary measures are indicated for preventing HIV from spreading to health care personnel and amongst hospitalised patients in Africa.