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Recommendation 6.1 Starting ART
Justification and evidence
The recommendation in this section addresses one PICO question:
PICO question (DR-TB, 2011): In patients with HIV infection and drug-resistant TB receiving antiretroviral therapy, is the use of drugs with overlapping and potentially additive toxicities, compared with their avoidance, more or less likely to lead to cure or other outcomes?⁵⁹
Source of recommendation
This recommendation was developed following the advice of the GDG convened in April 2021 to review data from a randomized controlled trial that assessed the safety and effectiveness of 4-month regimens for the treatment of DS-TB.
Justification and evidence
aDSM
active TB drug-safety monitoring and management
AFB
acid-fast bacilli
AIDS
acquired immunodeficiency syndrome
aIPD
adult individual patient data
Tuberculosis (TB) remains a threat to global public health and is one of the topmost infectious causes of death in the world. In 2022, an estimated 10.6 million people developed TB, and 1.3 million died from the disease. About 410,000 new cases of multidrug-resistant¹ or rifampicin-resistant tuberculosis (MDR/RR-TB) were estimated to occur in 2022. While all of these would have been eligible for a second-line TB treatment regimen, only 175,650 enrolments on treatment were reported by countries in the same year.