Question
What is the right time to start ARV treatment?
26 February 2008. Related: All topics, Newly diagnosed, Opportunistic infections, Starting treatment.
My brother who lives in Malawi was diagnosed HIV positive in November 2007. His CD4 count was 80. He has TB and started taking three TB pills. He had a bad reaction with rash all over his body. The doctors stopped him taking the three tablets for three weeks. They resumed treatment with different pills. The doctors are not giving him ARVS and meanwhile he tells me he is getting weaker. What is the right time for my brother to start taking ARVS?
Answer
Thank you for your question. Your brother was diagnosed with two very serious infections and a very low CD4 count. He really should be on antiretroviral therapy. Your brother’s doctors maybe worried about drug interactions between the TB drugs and the kind of antiretrovirals available in Malawi.
But people with HIV who have low CD4 counts and also need to take TB medication, should start on the TB drugs for at least two weeks to see how well they tolerate the drugs. If they can tolerate the drugs well, then they need to start on antiretroviral therapy as soon as possible. At least this is what the UK HIV guidelines suggest. Please do come back to us if you have any further questions.
im 25 i hv started takin da arvs by 28 december 2013 after i gv birth.bt nw iv gt rush all ova ma face n i think im growing some balls under my chick.wat must i do
Hi Pearl,
So called ‘boosters’ do not work. They don’t treat HIV and will not increase a person’s CD4 count.
Usually people start treatment when they have a CD4 count of 350 or below. If your sister’s doctor has said her CD4 count is low and she needs to start treatment it is likely that it is below this point.
You can help support your sister to learn about ARVs. She may be frightened of getting side effects but with modern HIV treatment these are usually mild and easy to deal with. Have a look at our guide to starting treatment to learn more and share this with your sister. By supporting her and finding out why she is reluctant to start treatment you may help her to feel more confident.
hi i have a sister who has been living with hiv for almost 6 years now,there was a time last year whereby she went to the doctor and was told that her cd4 count was low and had to start taking the arvs but she refused saying that there is a so called booster that she will take in order to boost her cd4 count this worries me a lot because she has been living wth the virus for too long now and i dont want to see her becoming ill so my question is,when is the right time to start taking the arvs?
Hi Viwe,
There are no foods that you or your husband need to avoid, and there are none in particular you should eat. It’s important to have a healthy and balanced diet though. Please follow this link for more information.
I tested hiv+ in 2011 when I went to deliver my daughter I was sooo shocked because I didn’t expect it. My husband has started on arvs and is on TB treatment he’s about to finish the TB treatment in April. I would like to know which foods we can we eat and what should we avoid eating?
Hi Thabit,
Please have a look at our Introduction to combination therapy guide, especially the section on when to start treatment, for information about this. Please let me know if you have any questions after looking there.
hi,my brother tested and have hiv he is still good and cd4 is 400 ,,so l need to know the right time to start arv
The doctors must have a particularly strong reason not to start as the current guidelines say that treatment should be initiated at a CD4 count between 350 and 200 and the closer to 350 the better. Does she have any other conditions?
Hi,
My wife tested positive in July 2007. Her health has been good till some few days ago when she started coughing and has some chest pain and lost some significant amount of weight. The doctors have refused to start her on ARVs. Her CD4 is 200. What do you advice we should do to ease the pain?
In this case the patient is already very ill because his immune system is weak.the antiretroviral therapy at this stage is very important to be started as soon as possible.In my practice I do meet some patient who don’t want to start ART because they feel too ill.I always tell them that tthey are ill because the immunity is weak and they need treatment to improve that immune system.