positive

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.

• 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.