13. When to Start HIV Therapy

View in chapter → Antiretroviral Therapy (ART) and Treatment of Persons Living with HIV and Active TB

Last Updated April 2026


HHS Panel Recommendations on treatment of Tuberculosis Disease with HIV co-infection: Timing of Antiretroviral Therapy (ART) Initiation relative to TB treatment
CD4 count and/or clinical status at time of TB diagnosis ART Initiation
< 50 cells/mm³ i within 2 weeks of starting TB therapy.
> 50 cells/mm³ i within 2-8 weeks of starting TB therapy
Pregnant, any CD4 count As early as feasible

Above based on guidelines developed by the Department of Health and Human Services (DHHS) Panel on Guidelines for Use of Antiretroviral Agents for Adults and Adolescents and Use of Antiretroviral Drugs in Pregnant Women with HIV Infection and Interventions to Reduce Perinatal Transmission in the United States, last reviewed and updated April 15, 2019
(https://clinicalinfo.hiv.gov/en/guidelines/hiv-clinical-guidelines-adult-and-adolescent-opportunistic-infections/mycobacterium?view=full).