Q and A


Side effects vs symptoms when starting meds with a low CD4?

Hello, my hubby & i started the HIV treatment Odimune.

My CD4 was 123 & hubby was 45. We have been taking the pill for a month but lately mi husband complains of headaches and back pain & his body temperature is high.

What could be the problem exactly coz at the clinic they say its only side effects.

Please help us so dat he gets better



Thanks for your question about your husband and for letting us post this online.

This is a really important question for anyone who starts treatment with a CD4 count below 100 and especially if it is below 50.

Although some of your husband’s symptoms could be side effects, the fever is more worrying. This is a reason to see the doctor.

People who start treatment when their CD4 count has already dropped to less than 50 have a risk of something called IRIS. This affects about 1 in 4 people (25%).

IRIS stands for immune reconstitution inflammatory syndrome). The is when an infection was present before treatment but that the immune system was too weak to fight. After treatment, the CD4 count gets stronger, and it recognises the infection.

This is very common with TB. It can also include CMV – which is why anyone with a CD4 count under 50 needs to have their eyes checked.

Because of the risk of IRIS, the clinic were not right to say these symptoms are side effects. Perhaps they didn’t know your husbands CD4 count was less than 50 when they talked to you.

Please contact the clinic again. Say you have this information from i-Base and that you want a doctor to see your husband to check it is not IRIS.


  1. Lisa Thorley

    Hi Kopee,

    What ARVs are you taking?

  2. Kopee

    I am hiv positive. .n ive started taking arvs. My cd4 is 638 ..I .always have headache. What is the problem

  3. Lisa Thorley

    Hi Kerryann.

    HIV’s no longer what it used to be. Its now a very manageable health condition. As long as your daughter starts ARVs then she’ll be fine. This is because its the ARVs that will control her HIV. There’s some guides on our site that you might find helpful, so stuff about starting medication and what it can feel like for someone to be diagnosed as well as living well with HIV and having kids. Please see here:

  4. Kerryann

    Hi my 18yrs old daughter just diagnosed with HIV and herpes can it kill her fast

  5. Lisa Thorley

    Hi Diana,

    If your daughter has just started Atripla its important that she goes and sees her doctor. This is because a rash can be a sign of a serious side effect. If she ins’t new to treatment, she will still need to see a doctor.

  6. Diana

    Hi,my daughter who is 19yrs is on Atripla and TB drugs.but she has a rash on her forehead and feet could that be a side effect,and also what is the best way to help her with the rash?

  7. Simon Collins

    Great – I hope everything goes well – please let me know if I can help with anything else.

  8. mathapelo

    thank u so for ur answer we will go bck to the clinic n ask them to check him

  9. Simon Collins

    Hi Wilson

    Your CD4 count is still very strong, so this is unlikely to be needed yet.

    In the UK, Septrin (also called co-trimixazole) is not usually needed if the CD4 count is above 200. In some countries, it is this cut off is above 350. Also, some people use these antibiotics at higher CD4 counts if it is being used as an active treatment, rather than to prevent infections.

    Please confirm this with your doctor because I don’t know what the guidelines are in your country.

  10. wilson

    I am HIV+ but my CD4 cells count is above 550. Should I start taking Septrin?


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