very_low

Xpert MTB/RIF should be used in preference to conventional microscopy and culture as the
initial diagnostic test for cerebrospinal fluid specimens from patients suspected of having TB
meningitis.

In settings with a high burden of HIV and TB, TB treatment may be provided for people
living with HIV in HIV care settings where a TB diagnosis has also been made.

In settings with a high burden of HIV and TB, ART should be initiated for people living with HIV
in TB treatment settings, with linkage to ongoing HIV care and ART.

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.

Amikacin may be included in the treatment of MDR/RR-TB patients aged 18 years or more on
longer regimens when susceptibility has been demonstrated and adequate measures to monitor
for adverse reactions can be ensured. If amikacin is not available, streptomycin may replace
amikacin under the same conditions.