A patient is diagnosed with HIV and Tuberculosis. How should ATT and c-A.R.T be staed?

Initiation of cA and/or anti-TB therapy may be associated with clinical deterioration due to immune reconstitution inflammatory syndrome (IRIS) reactions. These are most common in patients initiating both treatments at the same time, and may occur as early as 1 week after initiation of therapy, and are seen more frequently in patients with advanced HIV disease. For these reasons it is often recommended that initiation of cA be delayed in antiretroviral-naive patients until 2-8 weeks following the initiation of treatment for TB.