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.
I tested positive today same time they gave me arvs they said I must come nextweek for the CD count results is it right?
Hi Zama.
If your being sick, this is very likely to be morning sickness. This is common in the first trimester.
I’m not sure why the clinic have told you to wait until next month before you start meds. You’re pregnant, so you should be on them. Also the World Health Organisation now recommend that all positive people should be on medication and this is regardless of their CD4 count.
My advice would be to go back to the clinic and tell them that you want to start.
Hi am six weeks pregnant and HIV positive. I was at the clinic last week Thursday and I was told that I can only start the clinic next month and right now am feeling sick and I can’t keep anything down my throat, so should I go back or wait for next month, please help am afraid for my baby…
Hi Hlengiwe,
Even if your CD4 is now 1000 you still need to take ARVs. This is because if you stop taking them your CD4 will begin to drop and your viral load will increase.
If your viral load is undetectable, which it should be if you’ve been on meds for a year then its perfectly fine to have sex without using a condom. For more info, please see here:
http://i-base.info/htb/32308
You should though have your viral load confirmed.
Weight gain can be due to all sorts of reasons of which diet and exercise are included.
Hai I have been tested last year November and I have started my treatment sometime my cd4count was 668 and now is above 1000 should I stop taking them I’m not even sick my problem is in gaining wait I was using size 38 now 42 it’s possible that I can infect my partner if I’m having unprotected sex?
Hi Grace,
If your viral load is undetectable, then yes you can have unprotected sex. Please see here:
http://i-base.info/htb/32308
If, however your viral load is detectable then you risk transmitting HIV to your partner.
My partner is negative and I tested positive and now I am on treatment so can we have unprotected sex
Hi zaza,
Please see Q 4 here:
http://i-base.info/qa/what-are-the-most-asked-questions
Hy
I started my Arv treatment last month everything was fine …now it happens that I missed my dose for 2 nights is there a problem….please help I’m worried
Hi Bukeka,
What’s your CD4 count?
Its very common to be worried about possible side effects when starting ARVs. However, if you want to control your HIV you will need to take medication. Medication and medication alone will do this. For more info about starting meds, please see here:
http://i-base.info/guides/starting
With regards to changes in body shape, with modern day ARVs this is less common. Its also not guaranteed that you will have this sort of side effect even if you are already losing weight. Therefore, meds are the best option.