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 doc
recently started TB Treatment and tested positive they said l mst come bck afta two weeks to start ARV’s . is that ok ? they did not tell me how mch my cd4 is. m using RifafourE-275 , nucotrim 56 tablets, pryxodine as well as B.Complex
Hi T. Without more details about your CD4 count and how this changed over time is is difficult to comment. If you have symptoms, your doctor should find out what is causing this. If these symtoms are side effects from treatment, your doctor could give you different medicine.
I started treatment last year December after they tested me they gave me pills to prevent Tb before starting ARV’s.I went back to clinic those tb pills were making me dizzy they say I’m must stop them I did still I feel dizzy heavy headache and I had a little stroke it was my first taking but they say my result show as if I started a medication and stop it how possible is that I’m always sick I’m scared what should I do to keep my health good
Hi Anah,
Following up from yesterday. Can I just check that you mean viral load and not CD4.
Hi Anah,
A viral load of 33 is excellent. It means that you are undetectable. For more info please see:
http://i-base.info/ttfa/section-2/8-what-is-a-viral-load-test/
When a person has 33 viral load does it mean they are dying?
Hi,
I’m HIV+ and taking ARVs. Is it possible to take winthrop isoniazid for TB, while I tested negative?
Hi Mkhoshi,
Yes, winthrop isoniazid can be used to reduce the risk of TB. This is though something that you should talk to your consultant about.
Hi Patrica,
How are you feeling now that you’ve stopped taking the TB medication?
My CD4 was 632 I went to the clinic and they advised me to start ARVS and they gave me with Winthrop isoniazid I started to feel weak and dizzy all my joint are weak I went to the Doctor and he advised me to stop using Winthrop isoniazid and continue with ARVS only because I was never diagnosed with TB