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TB-HIV coinfection — DTM&H MCQ

Instant feedback + full explanation. One question, done properly.

ModerateHIV/AIDS in tropical settingsTB-HIV coinfectionDTM&H

A 42-year-old man with pulmonary tuberculosis is newly diagnosed with HIV in Uganda. CD4 count is 46 cells/mm³ and he has started rifampicin-based TB treatment. What is the most appropriate treatment?

Educational content. Not a substitute for clinical judgement or local policy.

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Correct answer: E — Start ART early with interaction-aware regimen

Start ART early with interaction-aware regimen is the single best answer because advanced HIV with TB requires early ART while accounting for rifampicin drug interactions. Defer ART until TB treatment ends is plausible in a related presentation, but it is less appropriate because it does not fit the key discriminator in this vignette. The teaching point is that delaying ART until completion of TB treatment increases mortality in severe immunosuppression.

Reference: WHO consolidated HIV guidelines; WHO advanced HIV disease guidance; Manson's Tropical Diseases