Module 4 - Special Situations

Special Situations

4.3

Tuberculosis and HIV - Ensure DOT for ART as well as tuberculosis treatment

	Patient-centred DOT, likely in the community, should be provided for all TB patients living with HIV as the adverse reactions and mortality associated with treatment interruptions are much greater than with TB patients without HIV infection.
	DOT strategies can be adopted for ART as well, at least during TB treatment. It may be helpful for early patient training. Coordination between TB and HIV services to provide joint DOT for both medications would be ideal. More information on management of HIV infection in TB patients can be found in WHO's TB/HIV A Clinical Manual.