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 (Norstan-Isoniazid) i was using this tablets when i was pregnant,so i can continue to use it again? And my cd4 is 436 I’m not in arvs what must I du?
Hi Nonku,
All pregnant women are recommended to take some type of ARVs to reduce the chance of passing HIV to their baby. Which ARVs you are recommended to take will depend on the TB meds you are using, how far you are in your pregnancy and what the guidelines for treatment are in your country. You can read more about treatment in pregnancy here.
Was pregnant ,on TB treatment with 527 CD4 count the Doctor suggested that I must also take ARV’s is that possible?
Hi Nombeko,
I’m sorry to hear about the problems you are having with your TB medication. Can I ask what ARVs and what TB treatment you are using? Sometimes HIV drugs and TB drugs have interactions and it’s important to check that the combination you are using is ok. There is information about this in our training guide.
Unfortunately it’s not unusual to experience joint pain when taking TB drugs. Your clinic should offer you with something to manage this pain though, and a doctor should check this to make sure it doesn’t require further treatment. Joint pain is not normally a reason to stop taking TB drugs, but it is important you get help dealing with this. If you let me know which country you live in I may be able to suggest an organisation that can support you if you are having problems getting appropriate care from your clinic. If you live in South Africa, for instance, you could contact the Treatment Action Campaign.
I’ve been on arv’s for 5 months as i started them with a cd4 count of 288,now i have tb of the abdomen and i’m on treatment for that too but my joints feels like hell even my hands,don’t know what to do as i mentioned it at the clinic several times with no help at all.
Hi Nick,
If you are taking any other medications you should speak to your doctor or pharmacist about this. This is because some drugs will have interactions with ARVS which may cause them to act differently in your body. What medications are you taking?
How long should i wait after taking Anti-retrovirals before taking other medications?Is it wise to wait for at least an hour or just taking them spontaniously will do no harm?
Hi Jabu,
I’m sorry but I can’t diagnose the cause of your night sweats. It’s important to talk to your doctor about this.
I tested hiv positive in january 2010 and my cd4 count was 94, tested negetive for TB but the docter still gave me treatment for TB, after two weeks on TB treatment I started ARVs and everything went right I gained weight and finished my TB treatment. But now I’m sweating a lot at nights, does this means maybe I got TB? I’m still taking my ARVs correctly.
Hi Cathy,
You will need to contact your mother’s doctor to find out how to deal with this. I-base is an HIV treatment information service and we are not experts in TB medication. Her doctor will be able to tell you whether this is likely to be a problem or not.