Except as specifically described below for people with HIV infection with low CD4 counts or
who are seriously ill, urine lateral flow (LF)-LAM should not be used for the diagnosis of TB.

ART should be started in all TB patients living with HIV regardless of CD4 count.

Infants and children living with HIV who have poor weight gain, fever or current cough, or who
have a history of contact with a person with TB, should be evaluated for TB and other diseases
that cause such symptoms. If TB disease is excluded after an appropriate clinical evaluation or
according to national guidelines, these children should be offered TB preventive treatment,
regardless of their age.

Adults and adolescents living with HIV should be screened for TB according to a clinical
algorithm. Those who do not report any of the symptoms of current cough, fever, weight loss or
night sweats are unlikely to have active TB and should be offered preventive treatment, regardless
of their ART status.

All individuals with active TB should receive
(i) an assessment of their nutritional status
and (ii) appropriate counselling based on their
nutritional status at diagnosis and throughout
treatment.

Partners of known HIV-positive TB patients should be offered voluntary HIV testing and counselling
with mutual disclosure.

All health workers should be given appropriate information and encouraged to undergo TB diagnostic investigation if they
have signs and symptoms suggestive of TB (see rest of recommendation p. 12 of the guideline).

For patients with confirmed MDR/RR-TB, SL-LPA may be used as the initial test, instead of phenotypic culture-based DST, to detect resistance to the SLIDs.

For patients with confirmed MDR/RR-TB, SL-LPA may be used as the initial test, instead of phenotypic culture-based DST, to detect resistance to fluoroquinolones.

The following treatment administration options may be offered to patients on TB treatment:
a) Community- or home-based DOT is recommended over health facility-based DOT or
unsupervised treatment;
b) DOT administered by trained lay providers or health-care workers is recommended over DOT
administered by family members or unsupervised treatment;
c) Video-observed treatment (VOT) may replace DOT when the video communication technology is available, and it can be appropriately organized and operated by health-care providers and patients.