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 Thuso,
If you’re having issues with the TB meds, please discuss this with your doctor.
Hi. I was tested positive for Hiv and negative for TB, but I was given Winthrop isoniazid, and since I started taking them am feeling very dizzy and my body is weak
Hi Fikile,
Being given anti TB meds is common when someone lives in a TB prone area. However your CD4 is good, therefore I don’t know why you’ve been given isoniazid. This is something that you should talk to your doctor about especially if you aren’t feeling well.
Hi I started ARVs didn’t experience any side affects. When I got my second batch of treatment I was given isoniazid and told I need to take for a year. Just told it’s to prevent TB. My CD4 count was above 500. No other explanation. I didn’t question as I thought it’s how it’s done but since taking it I get severe headaches, nausea and feel disoriented can I just stop taking it?
Hi Nony,
Taking isoniazid to prevent TB is a good idea if you have latent TB. But please discuss the side effects with your doctor. You can also ask about the result of your TB diagnosis and find out how much longer you need to take TB treatment.
You can ask if other TB meds would be easier for you to take.
I hv been taking my ARVs since 2016 and my CD 4count is above 500 jus this yr 2019 l wz told that I will be having isoniazid for the prevention of TB.And it’s making me feel very sick and lm now starting to lose weight.ls it okay if I stop taking it? Will it do any harm on me?
Hi Precious,
It’s important that you take the full course of meds to treat TB successfully. Please talk to the doctor about this and ask if you need more treatment.
Do you have access to your viral load? And what HIV meds are you taking? Please let us know.
On february 2019 i tested HIV positive and had to take medication from there,my cd4 count was over 1000,i was given tb treatment pills but i did not finished that tb treatment,can that harm me in future?
Hi Nomi,
Sometimes people will be given preventative medication if their CD4 count is low. Yours however isn’t. Therefore, I’m not sure why you’ve been given it. Do you live in a TB prone area? If you’re having side effects, please talk to a doctor about it. The following may also help: https://www.nhs.uk/conditions/tuberculosis-tb/treatment/
Hi
I started ARVs didn’t experience any side affects. When I got my second batch of treatment I was given isoniazid and told I need to take for a year. Just told it’s to prevent TB. My CD4 count was above 500. No other explanation. I didn’t question as I thought it’s how it’s done but since taking it I get severe headaches, nausea and feel disoriented can I just stop taking it?