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Tuberculosis — SCE Infectious Diseases MCQ

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ModerateTuberculosisTuberculosisSCE Infectious Diseases

A 35-year-old HIV-positive man (CD4 45 cells/µL) is diagnosed with pulmonary TB. He is not yet on ART. When should ART be initiated?

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Correct answer: A — Within 2 weeks of starting TB treatment

In patients with HIV and TB co-infection with a CD4 count <50 cells/µL, ART should be initiated within 2 weeks of starting TB treatment, as this reduces mortality. For those with CD4 >50, ART can be started within 8 weeks. The exception is TB meningitis, where early ART initiation (within 2 weeks) may increase adverse events, and ART should be deferred until at least 4–8 weeks after TB treatment initiation.

Reference: BHIVA 2022 – Guidelines on treatment of TB/HIV co-infection; WHO 2022 – Consolidated guidelines on HIV