If an HIV infection is present in addition to tuberculosis, this must also be treated. This requires at least three additional medications, which can often be taken together in a single tablet. As HIV weakens the immune system, treatment is extremely important to enable the tuberculosis to be cured. As a rule, vitamin B6 is also administered. However, HIV medication can interact with tuberculosis medication, which is why treatment should only be prescribed by specialized doctors. The time at which HIV therapy is started varies from person to person and depends on the function of the immune system.

Treating the HIV infection prevents HIV from multiplying in the body. The virus should no longer be detectable in the blood a few weeks later and the immune system can then recover. In some cases, treatment of the HIV infection causes a tuberculosis disease to worsen again or other infections to become visible. This can be a reaction of the immune system known as immune reconstitution syndrome (IRIS). An IRIS indicates that the immune system is recovering and is usually harmless, but sometimes requires temporary concomitant medication. However, it must be clarified whether it is really IRIS or whether the tuberculosis is worsening for other reasons. Other infections that become visible as a result of HIV therapy must also be treated accordingly.