Question
Am I still at risk of developing an OI?
11 January 2024. Related: All topics, CD4 and viral load, Newly diagnosed, Opportunistic infections.
I am diagnosed with a CD4 count of 60 on 28 oct 2023 with mouth candida. After 2 months of treatment I am feeling better. Am I still at risk of developing OI?
Answer
Hi, how are you doing?
It is great to hear that you are feeling much better after 2 weeks on treatment. Were you given anything specific to treat the mouth candida?
As you have a CD4 count below 200 it is recommended that you be on an antibiotic called co-trimoxazole (sometimes called Septrin or Bactrim). This is used to help prevent other infections while your immune system recovers.
Do you know what your current CD4 count and viral load is?
While your CD4 count is still low you are still at some risk of other OIs but the antibiotics and HIV treatment will help prevent this.
As your treatment continues to work and your CD4 count goes up, you will become more resistant to OIs until you have no additional risk similar to someone who is not living with HIV.
Josh.
Hi Sandy, it is great to hear that you have no symptoms. Thank you for explaining why you have been started on treatment. A low CD4 count can be used alone as a reason to initiate Tb prevention treatment.
But I am not tested for tb
. On basis of my cd4 ipt treatment started
And I have no symptoms.
Hi sandy, IPT treatment does not eliminate the risk of infection. Depending on your current Tb status it will either REDUCE the risk of a first episode of Tb OR help to prevent a recurrent episode.
Hi Josh,
once I complete IPT treatment, in coming years this treatment eliminate risk of being infected of tb
Hi Sandy, thanks for explaining further. Have these treatments been working? and have you been told how long you will be on Fluconazole for?
I think calcium and b complex given for bone pain I had in my elbow and flucnozole for mouth candila , when I was diagnosed 3 months ago I had mouth candila and given flucnozole and since then continue
Hi Sandy, I recognise that totalling these 8 tablets can seem like a lot especially as you are only 37 but you will not be on all of them forever.
ITP is not long-term. This is 1 month up to 36 months depending on your risk and the prevalence of Tb in your area. A side effect of isoniazid is numbness/tingling because of how it works. You are taking Vit-B6 to prevent this and when you stop isoniazid you will also be able to stop this supplement.
Septrin is an antibiotic used to prevent other infections as your immune system recovers. Depending on your countries recommendations you will no longer need to be taking this when your CD4 count is above 200/350.
Why have you been given Vit-B (separate from B6?), Vit-D and calcium? Are you taking these as additional supplements or are they being used to treat? and why are you taking fluconazole? It is unlikely this is a long term treatment.
Considering this it means eventually you will only be on your HIV ART plus any supplements you wish to take.
Thanks Josh,
I am taking IPT for TB
Vit-B6, Vit- B complex
Fluccozole
Septrin
Calcium and Vit D
In total 8 meds daily
That’s scary making me feel how I will survive taking these many tablets at this age of 37
Hi Sandy, do you have any support around you e.g., from friends, family, your doctor or other support groups?
When did you start HIV treatment and have you also been given an antibiotic called co-trimoxazole?
What are you afraid of? and how are you currently feeling about your health? It is good that your doctor has given you TB treatment and is being proactive about your care. Have you voiced your concerns to your doctor about feeling scared?
A CD4 count of 60 is low but it will increase over time. HIV treatment works by suppressing your viral load and often within 3 months it will be undetectable. When this happens HIV is no longer damaging your immune cells are your CD4 count will be able to recover. This can be a slow process as it is the body naturally regenerating itself but it will happen over time.
This is explained further here: https://i-base.info/qa/21386
My cd4 is 60 and now given today TB proxy tablet for 6 month
I am afraid