ART should be started at the same time as TB treatment.
If this is not possible, be sure TB treatment is started first and ART within the next 2 weeks.
Children on TB treatment and more than 3 years of age should start Regimen 4 (AZT/3TC/EFV).
If less than 3 years should start Regimen 2 (AZT/3TC/NVP) without the lead in phase or starter pack, as rifampicin reduces the levels of Nevirapine.
Do not start a child less than 3 years and on TB treatment on new Regimen 11 as requires major dose adjustment of LPVr.
Children diagnosed as having TB while on ARVs should start anti TB treatment as per national guidelines in the usual way.
Children on second line treatment that includes Lopinavir/ritonavir (reduce levels 60%) should not receive rifampicin but currently it is not possible to source Rifabutin. If there is no other possibility the dose of LPVr should be doubled until finishing treatment with Rifampicin.
HIV-infected children, even when on ART, require a full 6 months of Isoniazid Preventive Therapy (IPT) if in contact with a TB case and active TB has been ruled out IPT )