Patient diagnosed with HIV and Tuberculosis. How to sta ATT and c-A.R.T
Ans. is 'a' i.e., Sta ATT first In a case when HIV and TB are diagnosed together ATT should be staed first. ATT staed first, because of IRIS (Immune Reconstitution Inflammatory syndrome). If A staed 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, staing of ATT-2 weeks before A, have shown to decrease the incidence of IRIS.
Sta ATT first
Sta cA first
Sta both simultaneously
Sta cA only