This study adopts a multicenter, open-label, randomized controlled design, conducted across key designated AIDS diagnosis and treatment hospitals nationwide. It aims to compare the efficacy and safety of the 2HPMZ/2HPM regimen versus the 2HRZE/4HR regimen in treating HIV-associated drug-susceptible pulmonary tuberculosis (DS-TB) among patients with a CD4+ T-cell count < 100 cells/μL. A total of 148 participants will be enrolled and randomized 1:1 into two groups: 74 cases in the 2HPMZ/2HPM group and 74 cases in the 2HRZE/4HR group.

Inclusion Criteria:

• Age ≥ 18 years, able to understand and sign the informed consent form.
• Confirmed HIV infection.
• Baseline CD4+ T-lymphocyte count < 100 cells/μL.
• Confirmed active pulmonary tuberculosis.
• Agree to receive antituberculosis treatment and antiretroviral therapy during the study period.

Exclusion Criteria:

• Known or suspected resistance to any of the drugs in the regimen, including rifapentine, moxifloxacin, rifampicin, isoniazid, ethambutol, and pyrazinamide.
• Body weight < 40 kg.
• Received the current tuberculosis treatment for more than 7 days.
• Complicated with tuberculous meningitis or other severe forms of tuberculosis.
• Severe liver dysfunction (ALT or AST > 5 times the upper limit of normal, ULN). - - Severe renal dysfunction (eGFR < 30 mL/min/1.73m²).
• Baseline electrocardiogram (ECG) showing QTc interval > 500 ms.
• Pregnant or lactating women.
• Presence of other conditions deemed inappropriate for study participation by the investigators.