Treatment of HIV/Tuberculosis Co-Disease

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Objectives To conduct a randomised, open label study to test whether a strategy of initiation of antiretroviral therapy shortly after commencing tuberculosis chemotherapy (2 weeks) achieves a significantly improved outcome when compared to a strategy in which antiretroviral therapy is deferred until the induction phase is complete (2 months) Specific aims ¿ To evaluate the efficacy, safety and tolerability of two strategies for the management of HIV related TB disease ¿ To improve the clinical management of patients with HIV/TB co-disease ¿ To establish a system of direct observation of therapy for HIV related TB Methods ¿ The study will be conducted in both inpatient and outpatient settings in Thailand and Cambodia. ¿ All patients newly diagnosed with first episode tuberculosis and co-infected with HIV will receive standardised TB short-course chemotherapy. ¿ Patients will be randomised to receive antiretroviral therapy to commence either early in the course of tuberculosis treatment (at two weeks) or deferred until TB therapy has been completed (at two months). ¿ Patients in both arms will receive the same combination of antiretroviral drugs