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 gt, it is important to take all the meds that your doctor has prescribed. Each one will help you in different ways. Sputum tests don’t always find TB, but as your CD4 count is so low, the isoniazid is very important. Hopefully, everything will slowly start to get easier and your CD4 count will slowly increase.
Hiv pos and cd4 i now 18 but the sputam fin no tb but steal cough i took ex ray no tb at hosp they gave me amoxycluv ant the clinic says i must also use isoniazid and i cough a lot after taking ihavr two days using arvs help
Hi Vovo, please could you ask your doctor this. The isoniazid is protecting you agains TB, but it is used for different times depending on your personal circumstances.
when do i stop taking isoniazid im hiv positive but i do not have tb . The clinic say that is for prevention for tb not to occur
Hi Lithakazi, I am sorry to hear about your cousin. You would need to get this confirmed by the doctor, but if the vision loss was due to a virus called CMV, then I am sorry that this vision loss is permanent.
CMV is one of the serious late stage infections that is very common if the CD4 count drops to below 50 cells/mm3. About a third of people with counts this low will get CMV within a few years if they do get HIV treatment. The HIV treatment makes the immune system strong enough the then fight the CMV.
Hi my name is lithakazi I have a problem my cousin was have meningitis and her cd4 count is 7 that cause my cousin to loss vision and the doctor say she’s permanent blind she was very sick but she statertd arv’s now she’s much better I want to ask if there’s anything help she can get to bring her vision back even if it’s not back 100%. Thank u
Hi,
This does not necessarily mean anything has gone wrong. CD4 counts often jump up and down. Another test will show you if yours is consistently dropping. Multiple CD4 counts are usually looked at over a period of time to see if there is a trend.
I testesd positive and my CD4 was 395, after 3 months when I went back it went down. It was 370. I took the treatment regularly.What do u think went wrong?
Hi i tested positive in 2013 and my CD4 count was 427 last year 467 do i need to take ARVs?
Hi,
I’m sorry but I don’t understand your question. Did you stop taking isoniazid because you were pregnant?
Isoniazid is used to treat tuberculosis (TB). Do you have TB?