Question
Do I need to take ARVs as well as TB meds with a high CD4 count?
7 February 2023. Related: All topics, Opportunistic infections, South Africa, Starting treatment, TB.
I tested positive in South Africa in 2009 and my CD4 was 240 and in December 2010 I started treatment. It was for one month only. I was okay with it, it never gave me any problems but on the following month I never went to the clinic, so i started using Bactrim and some boosters.
Then in May 2011 I was raped by unknown guy and when they took my blood to check for my CD4, and the result was 500. At the same time they discovered that I’ve got TB. Now, since I am taking TB treatment, should I also start ARVs? I am worried.
Answer
NOTE: this question from 2011 has been updated to cover guidelines for HIV and TB treatment in 2023.
Thanks
The short answer is yes. Both these meds are really important.
It is especially important if you also have TB. And HIV treatment is recommended for everyone, even with high CD4 counts. This is an example of how guidelines have changed since you were diagnosed.
I am also sorry to hear about the assault. I hope you have been able to access care and support to help you get back to your life again. You are doing a great job at bring back your focus on your own health. This is important and your strength is an example to other people.
Your first CD4 results might just have been low if you were only recently infected.
In most people the CD4 recovers again, before it steadily drops over many years. It is great that your CD4 count has gone up, but the years that you were not on treatment would still have been damaging your immune system. You can still access treatment now if you go back to your clinic.
Unfortunately, there is no such thing as an ‘immune boosters’. This is just adverts and marketing. So-called ‘immune boosters’ will not help your CD4 count – only HIV meds can do this.
This question was updated in 2023 and 2021 from a question posted in 2011. This is because guidelines now recommended HIV treatment for everyone with TB.
Hi Buyiswa,
Yes its OK to take ARVs at the same time as TB meds, this won’t be an issue.
Can i take my ARVs with TB medication the same time at night?
Hi Lesego,
Sorry we are not doctors at i-Base. It’s great that you’ve started medication but it’s important you go to the doctor so they can look at your rash. It’s important to get it checked in case there’s a serious reaction to your meds.
Hi doctor what can one use for when having painful pimples all over my body I have just started with my medication and am losing self confidence help
Hi Emma,
Sorry, you don’t sound well at the moment. But please can you talk to your doctor about your TB treatment? Sometimes people who are HIV positive take TB drugs because they have latent TB. That means the TB is not active but it could start to be. So drugs are taken to stop it.
Please talk to your doctor about your painful feet and your eye problems. It’s important to talk about any problems you have with your eyes. These could be side effects of your meds. And you can ask your doctor if different meds will be any better.
I also started ARV in 2012 and I started gaining weight no they have given me tb treatment wich I don’t have . My feet is painful.and I have tears in my ears because of tb medications what must I do
Hi Nontsindiso,
What treatment are you taking? HIV and TB can be treated together but this needs specialist treatment. Especially as you have a low CD4 count. It’s important that you talk to the doctor about how they are treating you. You can ask about what ARVs you are given and what drugs you’ll have to take for the TB.
My Cd4 is 25 after 1 month that I am using treatment doctor found out that I’ve been diagnosed with TB is there a possibility that I can be sick
Hi Primrose,
I’m sorry to hear your husband is weak and in pain. But is he also on HIV treatment (ART)? If you have active TB you should be on ART. But if your CD4 count is low, TB drugs may be started first. Depending on your CD4 count your doctor may start your TB treatment first and may delay ART for up to twelve weeks. Once started, ART controls HIV and gives the CD4 count the chance to recover. Having a higher CD4 count can make him stronger in resisting infections.
my husband is on tb treatmant nd he is hiv positive,he is so weak and his feet are painful,what he can do to bacome trong and to ease the pain?