Question

I have just been diagnosed and my doctor didn’t explain CD4 or viral load.

27 March 2022. Related: All topics, CD4 and viral load, HIV transmission, Newly diagnosed, Pregnancy, Sero different couples, Side effects, Starting treatment.

Hello, I just found out I am HIV positive In February 2022. The result came out after I missed my period and my bf and I were trying to have a baby. His test was done before me as routine and it was negative, by the time he did his test we had been together for 3 months. I hope and pray he still negative since I have not told him.

I want to start my treatment and I have a lot of questions and concerns about the pills the doctor gave me, one pill that contains (efavirenz 600mg, tenfoir 200mg, emtricitabine 300mg) and another containing antibiotics.

Firstly my confusion is he didn’t explain much about my CD4 count or viral load, he only told me it was too advanced. All I can see from the test is “ positives lymphocytes CD4 —— 167 cel/Ul less/equal to 350cel/ul“, now I don’t know what that means in terms of viral load and CD4. Now I want to know if I would be able to have kids if I start taking my meds and also if I don’t tell my bf and he turns out to be positive is that going to affect my medication? The thing is we had never used a condom before my results.

What is the best hour to take these pills? I don’t want to deal with insomnia or nightmares. Please I was sacred at the beginning but thank God my mother is supporting me.

Answer

Answer: Josh Peasegood

Hi, I am sorry to hear that you have only just got your diagnosis but it is great to hear that your mother is supporting you.

CD4 count and viral load are both measures to see how active HIV is in the body. CD4 looks at how HIV has effected your immune system and viral load looks to see how quickly HIV is replicating.

In someone without HIV it would be expected that their CD4 count would be between 430 and 1690. Your results show that your CD4 count is 167. This means that HIV has effected your immune system and that you are more vulnerable to infection – this is why you have been given antibiotics. Starting medication means that this number will likely go up and your immune system can recover. It’s possible to get high enough that you will not need to be taking these antibiotics.

Is there a reason you do not want to tell your bf about your status? I know that disclosing can be very personal and it is most important that you feel safe to do so, so please do not feel that you have to. Though, while you are only starting your medication it means that you can still pass on HIV and putting your bf at risk. If he agrees to using a condom or you wait a few months for your viral load to become undetectable there will be no risk to your bf.

If your boyfriend becomes positive it will not affect your medication.

Starting medication can be scary but it is the only way to make sure you keep healthy. It will also help you become pregnant and prevent transmission to baby. Conceiving can be harder with lower CD4 counts but as your medication works and your CD4 count rises this will stop being an issue.

Your medication contains efavirenz. This drug is known to cause mood disturbances which is why it is recommended to be taken in the evening before bed. This way you will be able to sleep through the side effects. Make sure not to take this medication with a high fat meal. The high fat increases how much efavirenz is absorbed and can make the side effects worse.

Also, when starting people often experience heavier side effects but this should lessen as your body adjusts. if the side effects do get worse or you cannot tolerate them please speak to a doctor.

If you have any further questions please get in touch,

Josh.