Children aged < 5 years who are household contacts of people with bacteriologically
confirmed pulmonary TB and who are found not to have active TB on an appropriate clinical
evaluation or according to national guidelines should be given TB preventive treatment even
if LTBI testing is unavailable.
Adults and adolescents living with HIV who are unlikely to have active TB should receive TB
preventive treatment as part of a comprehensive package of HIV care. Treatment should be
given to those on antiretroviral treatment, to pregnant women and to those who have previously
been treated for TB, irrespective of the degree of immunosuppression and even if LTBI testing
is unavailable.
Adults and adolescents who are living with HIV, have unknown or positive tuberculin skin test
(TST) status and are unlikely to have active TB should receive at least 6 months of IPT as part of
a comprehensive package of HIV care. IPT should be given to such individuals irrespective of the
degree of immunosuppression, and also to those on ART, those who have previously been treated
for TB and pregnant women.
TB patients with known positive HIV status and TB patients living in HIV-prevalent settings should
receive at least 6 months of rifampicin treatment regimen (strong recommendation, high-quality
of evidence). The optimal dosing frequency is daily during the intensive and continuation phases.
Efavirenz should be used as the preferred non-nucleoside reverse transcriptase inhibitor in patients
starting ART while on antituberculosis treatment.
Routine co-trimoxazole preventive therapy should be administered in all HIV-infected patients with
active TB disease regardless of CD4 counts.
For the continuation phase, the optimal dosing frequency is also daily for these
patients.
TB patients with known positive HIV status and all TB patients living in HIV prevalent settings should receive daily TB treatment at least during the intensive phase.
New patients with TB should not receive twice weekly dosing for the full course
of treatment unless this is done in the context of formal research.
Wherever feasible, the optimal dosing frequency for new patients with pulmonary TB is daily throughout the course of therapy.