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These guidelines are published on the WHO website and can also be freely downloaded from the WHO TB Knowledge Sharing Platform.⁵ Implementation considerations are also reflected in the TB/HIV operational handbook (7).
To develop the TB/HIV guidelines, WHO mapped the WHO publications containing recommendations on HIV-associated TB, which had been formulated by the respective GDGs and approved by the WHO Guidelines Review Committee (GRC). All the recommendations included in these guidelines were developed in accordance with the WHO guideline development process, as outlined in the source guidelines. A full list of the source guidelines that were used to consolidate all WHO recommendations and inform the TB/HIV guidelines is provided in Box 1.1.
The TB/HIV guidelines are intended for managers of national TB and HIV programmes at all levels of the health system, managers in the private-for-profit sector, and other decision-makers in the health system. They are also a useful resource for clinicians and other healthcare providers, including community-based and primary care, harm-reduction services and maternal and child health programmes, as well as for relevant line ministries working on HIV-associated TB, such as ministries responsible for prisons or mining services.
The overall goal of the TB/HIV guidelines is to reduce suffering and death due to TB and HIV, in alignment with the WHO End TB strategy (3), the Global health sector strategies on, respectively, HIV, viral hepatitis and sexually transmitted infections for the period 2022–2030 (27), the Global AIDS Strategy 2021–2026 (28), the political declaration of the UN High-Level meeting on the fight against TB 2023 (29) and the UN High-Level Meeting on AIDS 2021 (5).
The specific objectives of the TB/HIV guidelines are to:
The TB/HIV guidelines summarize the recommendations and related evidence on interventions to reduce the burden of TB among people living with HIV and on interventions to reduce the burden of HIV among people with presumed or diagnosed TB, updating the recommendations outlined within objectives B and C from the TB/HIV policy as depicted in Fig. 1.
Since the WHO policy on collaborative TB/HIV activities (10) was published in 2012, there have been remarkable scientific advances and consequently, updated WHO recommendations on screening, diagnosis, treatment and prevention of HIV-associated TB. These include:
People living with HIV are about 14 times more likely to develop TB disease, have poorer TB treatment outcomes and have more than two-fold higher mortality during TB treatment, compared to all people diagnosed with TB (1).
People living with HIV are about 14 times more likely to develop TB disease, have poorer treatment outcomes and more than two-fold higher mortality during TB treatment, compared to all people diagnosed with TB (1). Addressing HIV-associated TB through integrated patient-centred care and prevention is a key component of the WHO End TB strategy (3).
Note: The definitions listed below apply to the terms as used in these guidelines. They may have different meanings in other contexts.
Adolescent: a person aged 10–19 years.
Adult: a person over 19 years of age.