(1) There are interactions between anti-HIV drugs and anti-TB drugs, such as the interaction between rifampicin and non-nucleoside reverse transcriptase inhibitors, which can reduce the effective blood concentration of the latter. (2) Concurrent antiviral and antituberculosis therapy may reduce adherence to treatment and increase adverse drug reactions. (3) Simultaneous treatment of both diseases increases the drug burden of patients. (1) All HIV-positive patients should be screened for tuberculosis at least annually by chest X-ray and sputum smear, as China is a high burden country for tuberculosis. For immunocompromised patients, it is often relatively difficult to diagnose TB through sputum examination and chest radiographs alone. Therefore, clinicians should be more alert to TB-related symptoms and pay attention to asking patients whether they have symptoms such as fever, cough, weight loss, and whether any family members are infected with TB, which are crucial to the diagnosis of patients with HIV-associated TB. (2) Patients with active TB should be isolated from the general HIV-infected population (including separate consultation rooms, separate wards, etc.) until the presence of one of the following three conditions: ① negative sputum smears on three consecutive occasions on alternate days; ② receiving anti-TB treatment for at least two weeks and preferably completing treatment under DOT; and ③ significant improvement in clinical symptoms of TB [WHO TB]. (3) Those patients with a history of close contact with open TB should be promptly evaluated for active TB disease. This should be done in conjunction with a national TB control program. (4) Some patients may develop new TB symptoms during antiviral therapy, especially in the early stages of antiviral therapy. If TB infection develops within 3 months of starting ART, clinicians should be highly suspicious of the possibility of tuberculous immune reconstitution syndrome. If a patient is diagnosed with TB 3 months after initiation of ART, TB treatment should be initiated and a referral made to a superior physician for reassessment of immune reconstitution or treatment failure (see Chapter 4, “Determination of Treatment Failure and Second-Line Regimens,” for details). (5) Because rifampin interacts significantly with protease inhibitors and non-nucleoside antivirals, rifabutin interacts less with antivirals and can be used in combination with nucleosides, non-nucleosides, and protease inhibitors; therefore, rifabutin can be used instead of rifampin for the treatment of TB. For patients with AIDS combined with tuberculosis, rifapentine should be avoided instead of rifampicin for the treatment of tuberculosis. (6) Anti-tuberculosis treatment is usually intensive treatment with INH+RIF+PZA+EMB for 2 months (intensive phase) and maintenance treatment with INH+RIF for 4 months (maintenance phase). Daily treatment with a DOT strategy is recommended for the intensive phase and at least 3 weekly regimens supplemented with a DOT strategy for the maintenance phase. The duration of antituberculosis treatment for patients with HIV-associated TB is controversial. The CDC recommends that most patients with HIV-associated TB have a good outcome on standard antituberculosis therapy (6 months), but the outcome for patients with advanced HIV-associated TB is not well understood. It is recommended that the course of antituberculosis treatment may be extended to 9 months if the patient has a cavity on chest radiograph or has clinical symptoms or a positive bacteriological test (sputum smear/sputum culture) after two months of antituberculosis treatment. (7) Clinicians should evaluate anti-tuberculosis efficacy based on clinical manifestations, bacteriology, laboratory tests, and imaging findings in patients with HIV-associated tuberculosis. For patients with tuberculosis, sputum smear and culture should be performed at least once a month until 2 consecutive sputum cultures turn negative. If the sputum culture is still positive after 3 months of antituberculosis treatment, the drug sensitivity test for Mycobacterium tuberculosis should be performed again. If the sputum culture is still positive after 4 months of anti-tuberculosis treatment, it is considered that the anti-tuberculosis treatment has failed and needs to be treated accordingly (e.g. drug sensitivity test, drug change according to drug sensitivity, etc.). (8) For patients already taking ARV drugs, if TB is diagnosed, anti-TB treatment can be started immediately and the original antiviral regimen can be evaluated and switched to a regimen containing EFV. For patients on NVP prior to antituberculosis treatment, after curing TB, they can continue to use a regimen containing EFV or consider switching back to the original regimen containing NVP; when switching back to the original regimen, a lead-in period for NVP is not required. (9) Patients’ tolerance and compliance with anti-TB drugs should be assessed monthly.