This is a real-world medical entrance exam question, please give the true answer based on the question and selection. Topic name: RNTCP, Subject name: Social & Preventive Medicine
[{'content': 'A 45 years old male patient comes to OPD with cough and diarrhea since last 3 weeks. On diagnosis he is found to be HIV positive with Tuberculosis, Next line of management should be:- \nSelect and explain. \nA. Sta ATT followed by A, B. Sta A followed by ATT, C. Sta ATT, D. Sta A then sta ATT after 6-8 weeks', 'role': 'user'}, {'content': 'Answer: A \nExplanation: Guidelines for treatment of HIV+TB patients:- A is offered to all HIV-TB and HIV-MDR TB patients irrespective of CD4 count. Sta ATT first, allow it to be tolerated , then sta A. ATT treatment is same but treatment is more difficult and adverse reactions are more common. Immune reconstitution inflammatory syndrome (IRIS) : Occasionally, patients with HIV-related TB may experience a temporary exacerbation of symptoms, signs ofradiographic manifestations of TB after beginning TB treatment. This paradoxical reaction occurs in HIV-infected patients with active TB and is thought to be a result of immune restitution due to the simultaneous administration of antiretroviral and tuberculosis medication. Symptoms and signs may include high fever, lymphadenopathy, expandingintra-thoracic lesions and worsening of chest radiographicfindings', 'role': 'assistant'}]