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 Thando,
Yes, it’s OK to take your TB meds in the morning, this is fine.
Hie l was recently diagnosed with HIV a week ago.l was given TLD arvs together with isoniazid and vitamin b6 tablets.My cd4 count is above 700.l take my arvs at 9pm and l was told to take TB prevention tablets (isoniazid)morning after meals and l take them 2hrs after breakfast is it okay.
Hi Lucas,
The reason why you’ve probably been given the novatrim is because your CD4 count is 240. Once this gets to 350 you’ll no longer need to us it. Novatrim is an antibiotic, which includes the following: sulfamethoxazole and trimethoprim. It’s safe to take.
Odimune and Atrozia are both generic versions of an ARV called Atripla. It’s common to take various generic versions of this. Given that you were off medication for 2 months, if you can please ask your doctor why you’ve been given the same ARV combination.
I want to ask my viral load is 2.657 and my cd4 count is 240 and they change my treatment to odimune and novatrim after I was using atrioza so I didn’t take my pills for 2 months is it the right decision to make the nurses to change to odimune and novatrim?
Hi Pinkie,
It’s great to hear you’ve started taking ARVs again.
But this high viral load looks like the ARVs are not working well. That can happen if we stop taking our meds for a while. But it’s important to talk to your doctor about it. You can ask if there’s HIV resistance to your old ARVs. If so, you can ask to switch to other HIV meds that will be better for you to take.
Novatrim is an antibiotic. Please also ask your doctor about your CD4 count to check that it’s not too low. Taking antibiotics can stop other infections if CD4 is low.
Please let us know what ARVs you’ve been taking. If you have access to your CD4 count please tell us what it is.
Hi I’m HIV positive and I was on medication until I stopped last year December and I started again this year July but now the problem is my viral load is high over thousand at the clinic they gave me novatrim to take with my ARVs, so can this help with the high viral load??
Hi Kedibone,
I’m sorry to hear about your recent diagnosis. Testing HIV positive can be a shock for all of us. But please see this post about if you’ve just found out you’re HIV positive.
So, even if you feel worried, frightened, upset or angry now, it will get easier. You will still be able do all the things you wanted to do before you learned that you were HIV positive.
We are not doctors at i-Base. But we give treatment info to people who are HIV positive. Many of us at i-Base are HIV positive. I’m HIV positive too.
So it’s a good idea to talk to your doctor about starting HIV treatment (called ART). Please see this guide to starting ART.
Please stay in touch and let us know how you get on. And if you live in South Africa you can contact the Treatment Action Campaign at this contact link. They can give local support.
Hi doc
I’m 20 years of age, I’m so devasted by the fact that I just find out about my HIV status when I wanted to go for circumcision. I’ve never used any treatment, I’m so angry at my mom because I’m not sexually active and it means I was born with this HIV. What must I do now??
Hi Aloeh,
Isoniazid is an antibiotic. It can sometimes used to protect against TB. But what did your doctor say? Please discuss this with your doctor.
And how’s the HIV treatment going? What ARVs are you taking? And if you have access to your CD4 and viral load results, please let us know what they are.
I am on ARVs and this month my doctor gave me Winthrop isoniazid pills I’m not sure if I must take it in the morning or at night when I’m taking my ARV.