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The optimum time to start antiretroviral therapy (ART) in a HIV infected patient receiving antituberculosis therapy (ATT) is unknown.1 2 Concurrent treatment of tuberculosis (TB) and HIV is complicated by poor adherence from high pill burden, overlapping toxicities, pharmacokinetic drug–drug interactions and risk of immune reconstitution inflammatory syndrome (IRIS).2 The risk of disease progression if ART is delayed has to be balanced against the risk of needing to discontinue treatment if ART is started soon after initiating ATT. We examined factors influencing delay in initiation of ART in patients taking ATT and compared our practice against British HIV Association (BHIVA) HIV/TB treatment guidelines.3
We retrospectively reviewed the case notes of coinfected ART naive patients attending a central …
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