Patient diagnosed with HIV and
Tuberculosis. How to start ATT and c-
A.R.T
a) Start ATT first
b) Start cART first
c) Start both simultaneously
d) Start cART only
Correct Answer - A
Ans. is ‘a’ i.e., Start ATT first
In a case when HIV and TB are diagnosed together ATT should be
started first.
ATT started first, because of IRIS (Immune Reconstitution
Inflammatory syndrome).
If ART started first, it may improve CD4 cells at first, but later a
previously acquired infection (TB, Herpes), responds with an
overshelming inflammatory response that paradoxically makes the
symptom of infection worse.
Therefore, starting of ATT-2 weeks before ART, have shown to
decrease the incidence of IRIS