Thanks for your post.
There's much to your patient that I'm curious about- for example, what is his current CD4 count; what type (or anatomic location) of TB does he have?
My first concerns is whether his tuberculosis is clinically improving or worsening- it will be very important to know this, since in many locations, the risk of drug resistant TB raises the possibility of recurrence of disease. It's possible that your patient is having a reaction to one of his TB medications-- this can often result in fever too.
Based on the limited information that you've supplied so far, it's difficult to say that your patient needs to initiate HAART, but rather, attention should be focused on understanding the basis of his fever.
Many physician's would wait to initiate HIV medications for at least a couple of months following initiation of TB medications, in order to decrease the risk of immune reconstitution reaction (IRIS). In this regard, your postponement is reasonable and consistent with the idea that you can defer initiation of HAART until the fever issue is sorted out.
Best of luck, BY
