Before starting tb prophylaxis in hiv patients how do we rule out active tb?

before starting tb prophylaxis in hiv patients how do we rule out active tb?

Just by clinical exclusion(4 symptom tool) or labs- cbnaat, sputum?

I think CBNAAT must be preferred, coz of high accuracy rates… Since mcc of death in HIV pt is TB, we have to rule out TB precisely to be on the safer side.