Children living with HIV who have any of the following symptoms – poor weight gain, fever or
current cough or contact history with a TB case – may have TB and should be evaluated for TB and
other conditions. If the evaluation shows no TB, children should be offered IPT regardless of their
age.

Efavirenz should be used as the preferred non-nucleoside reverse transcriptase inhibitor in patients
starting ART while on antituberculosis treatment.

Antituberculosis treatment should be initiated first, followed by ART as soon as possible within the
first 8 weeks of treatment. Those HIV positive TB patients with profound immunosuppression (e.g. CD4 counts less than 50 cells cells/ mm3) should receive ART immediately within the first 2 weeks of initiating TB treatment.

ART should be started in all TB patients living with HIV irrespective of their CD4 counts.

Routine co-trimoxazole preventive therapy should be administered in all HIV-infected patients with
active TB disease regardless of CD4 counts.

All people living with HIV with CD4 counts of ≤350 cells/mm3
irrespective of the WHO clinical stage
should start ART.

All children living with HIV after successful completion of treatment for TB disease should receive
isoniazid for an additional 6 months.

In children living with HIV who are less than 12 months of age, only those who have contact with a
TB case and who are evaluated for TB (using investigations) should receive six months IPT if the
evaluation shows no TB disease.

Children living with HIV who are more than 12 months of age and who are unlikely to have active
TB on symptom-based screening and have no contact with a TB case should receive six months
of IPT (10mg/kg/day) as part of a comprehensive package of HIV prevention and care services.

Adults and adolescents living with HIV should be screened for TB with a clinical algorithm; those
who report any one of the symptoms of current cough, fever, weight loss or night sweats may have
active TB and should be evaluated for TB and other diseases.