CD4 and tuberculosis: Delay in ART initiation might have been related to the clinician's consideration to reduce the risk of developing immune reconstitution inflammatory syndrome (IRIS).29 A recent meta-analysis showed that in PLHIV with TB and with low CD4 cells (<50 cells/μl), early ART (≤4 weeks) is associated with a higher risk of IRIS but also decreased mortality compared with delayed ART (>4 weeks).29 This shows the complex balance that clinicians need to consider when managing these patients, as they are the ones at greater risk of IRIS but also the ones who will benefit most from early initiation on ART.