Children aged ≥ 12 months living with HIV who are considered unlikely to have active TB
on an appropriate clinical evaluation or according to national guidelines should be offered TB
preventive treatment as part of a comprehensive package of HIV prevention and care if they live
in a setting with high TB transmission, regardless of contact with TB.

Infants aged < 12 months living with HIV who are in contact with a person with TB and who
are unlikely to have active TB on an appropriate clinical evaluation or according to national
guidelines should receive TB preventive treatment.

In settings with high TB transmission, adults and adolescents living with HIV who have an
unknown or a positive LTBI test and are unlikely to have active TB disease should receive at least
36 months of daily isoniazid preventive treatment (IPT). Daily IPT for 36 months should be given
whether or not the person is on ART, and irrespective of the degree of immunosuppression,
history of previous TB treatment and pregnancy, in settings considered to have a high TB
transmission as defined by national authorities.

Either a tuberculin skin test (TST) or interferon-gamma release assay (IGRA) can be used to
test for LTBI.

The absence of any symptoms of TB and the absence of abnormal chest radiographic
findings may be used to rule out active TB disease among HIV-negative household contacts
aged ≥ 5 years and other risk groups before preventive treatment.

Chest radiography may be offered to people living with HIV on ART and preventive treatment
be given to those with no abnormal radiographic findings.

Adults and adolescents living with HIV who are screened for TB according to a clinical algorithm
and who report any 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 and offered preventive treatment
if active TB is excluded.

Systematic LTBI testing and treatment is not recommended for people with diabetes, people
who engage in the harmful use of alcohol, tobacco smokers and underweight people, unless
they also belong to other risk groups included in the above recommendations.

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.

For people with severe mental disorders and TB, non-pharmacological (social, psychological) management
should be considered in accordance with the WHO guidelines for the treatment of drug-susceptible tuberculosis
and patient care and the WHO treatment guidelines for drug-resistant tuberculosis.