Patients with TB and HIV should receive prompt coordinated treatment for both conditions
People with HIV or diabetes, who are taking immune-suppressing medications, or who smoke or abuse drugs, are at higher risk for developing TB disease once infected. Patients often are diagnosed with HIV and TB at the same time. In 2003, when the previous TB guidelines were developed, patients with HIV usually did not start their anti-retroviral therapy (ART) until after TB treatment was completed, unless the immunosuppression from HIV-infection progressed. Recommendations for timing of initiation of ART have since changed. "Data from numerous trials have made it very clear that patients with HIV should begin treatment with anti-retroviral therapy (ART) during TB treatment, and not wait until after TB therapy is completed," said Payam Nahid, M.D., M.P.H., lead author of the guidelines and professor of medicine at the University of California, San Francisco School of Medicine. "Research shows that all patients with TB and HIV should receive treatment for both conditi...