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.
Hie today i took my fone to research on effects of rifafour on hiv positive patients:i did ths bcz last week my hubbie n i tested positive.my cd 4 count is 479 n his is 265.howeva i tested positive for tb as well n started my meds last nyt.my husband should b starting on his arvs on wed after they finishing their full blood count n everythng.am so scared n confused tht tb meds wil get me sicker howeva ur site has shed light am determined to take my medication n live longer as we hv a three yr old dota.hweva do u recommend tht i take boosters .
Morning,
My friend tested HIV positive and they said her CD 4 count is 13, tested negative for TB and Negative for Womb cancer and now they say she needs to take ARV’s and the Dr. Said she’s a very strong woman cause people with her CD4 count are laying in beds at hospital and she’s walking and doesn’t look weak. My question is how possible is it that she have such a low CD4 count and be so strong ?
Hi,
Congratulations on the birth of your baby! It’s not unusual to have a couple where one person is positive and the other negative. This is called being ‘sero-different’. The following link explains the risk of sexual transmission between sero-different couples. Please also take a look at this link for similar questions about sero different couples
Hi
I tested hiv+ while I was pregnant but my husband and our baby are negative how is that possible?
Tested positive and CD4 count is 75. Can ARVs boost it to 500? Am really scared.
Hi Allen,
HIV treatment is very effective and even with a CD4 count under 100 if you follow your treatment carefully, you have a good chance that treatment will work. Your viral load should drop to undetectable within a few months of starting treatment and your CD4 will rise to higher levels. Your CD4 might take quite some time to increase but it should reach healthier levels in time. Some people can still reach 500 when their starting CD4 is under 100. Please take a look at this graph for an idea of average CD4 increases by starting CD4 count.
Hi
Sorry for missing this comment earlier – I hope you and your baby are doing well.
Treatment is used differently in some countries. This is often to do with treatment access and the types of treatment available. In the UK a women with a CD4 count of 350 would probably use a three drug combination and then stay on this combination afterwards.
However, if in your country people don’t start treatment until 200 – there still a few places where this happens – then you will probably still do well, even though it is not ideal. Over time, your CD4 count will slowly go down, and then you will need treatment. It might also go up a little now as pregnancy causes the CD4 count to be a little lower.
It is best to ask your doctor about the TB treatment because you don’t include much information in your post. Vitamins are good if you already have a deficiency or poor diet, but they probably will not help your CD4 count directly.
Hi, I’m 9 months pregnant and tested positive when I was 5 months at my local clinic, my cd4 count was 380 and was told I won’t take the arvs because it above 350 but immediately given the AZT 300mg which are meant to protect the baby and Norstan-Isoniazid which are said to protect me from TB though I never tested for it, I was told that after birth i’ll stop both treatment and start taking multivitamin called centrum tablets and my question to you is will I be able to maintain my cd4 with these multivitamin, and with this Tb prevention iv been using how accurate is it that I won’t get TB coz I started the on feb till end of May which is when my baby is due?
Ideally you don’t want to miss any doses of your TB meds.
If you missed a few days when you were in hospital, then it is important to go back to taking them again now. This assumes that there was not a medical reason for stopping before.
Please tell your doctor about the details so they are informed. Hopefully these few days will still be ok.
Hi
I wnt 2 know if u stop taking TB treatrment for few days then go back 2 them will it affect me or what? I stopped cause I was in Hospital 4 seven days, then when I. Came back I took dem. I take de required dosage of my weight which is 48 I take 3 tabs a say