Antiretroviral therapy is recommended for all patients with HIV and drug-resistant TB requiring
second-line antituberculosis drugs irrespective of CD4 cell count, as early as possible (within
the first 8 weeks) following initiation of antituberculosis treatment.

• Ventilation (i.e. natural and/or mechanical).
• Upper-room ultraviolet germicidal irradiation.

• Protective equipment (particulate respirator masks that meet or exceed N95 standards
set by the CDC/NIOSH or the FFP2 standards that are CE certified) should be provided
for health workers caring for patients with infectious TB (suspected or confirmed).

• Inform and encourage health workers with TB symptoms to undergo TB diagnostic
investigation as well as HIV testing and counselling.
• Provide a package of care for HIV positive-workers (ART and isoniazid preventive therapy).
• Relocation for health workers living with HIV to a lower-risk area.

• A triage system should be in place to identify people suspected of having TB and minimize
diagnostic delays with rapid diagnostics e.g. Xpert MTB/RIF.
• Separate people with suspected or confirmed TB
• Ensure cough etiquette and respiratory hygiene
• Minimize the time spent in health-care facilities (e.g. through community-based approaches).

All children living with HIV, after successful completion of treatment for TB, should receive IPT for an additional 6 months.

TB treatment should be initiated first, followed by ART as soon as possible within the first 8
weeks of treatment.

In children living with HIV who are less than 12 months of age, only those who have contact
with a TB case and who are evaluated for TB (using investigations) should receive 6 months of
IPT if the evaluation shows no TB disease.

Children living with HIV who are more than 12 months of age and who are unlikely to have
active TB on symptom-based screening and have no contact with a TB case should receive 6
months of IPT (10 mg/kg/day) as part of a comprehensive package of HIV prevention and care.

Children living with HIV who do not have poor weight gain, fever or current cough are unlikely
to have active TB. Children living with HIV who have poor weight gain, fever or current cough
or contact history with a TB case may have TB and should be evaluated for TB and other
conditions. If the evaluation shows no TB, they should be offered IPT preventive therapy
regardless of their age.