<prompt> A patient is diagnosed with HIV and Tuberculosis. How should ATT and c-A.R.T be staed?Sta ATT firstSta cA firstSta both simultaneouslySta cA only  <response>: Initiation of cA andor anti-TB therapy may be associated with clinical deterioration due to immune reconstitution inflammatory syndrome IRIS reactions. These are most common in patients initiating both treatments at the same time, and may occur as early as 1 week after initiation of therapy, and are seen more frequently in patients with advanced HIV disease. For these reasons it is often recommended that initiation of cA be delayed in antiretroviral-naive patients until 2-8 weeks following the initiation of treatment for TB. 