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,im Hiv positive and my Cd4 count is 89,been 6 months on the treatment and on the 24 of July I had an operation on my left epididymis because of the tb that was on it,I went to the clinic to register so that i can start with my treatment,
And the nurse without even confirming my Cd4 count gave me Rifafour-275e,and suggested that for the ist two weeks I’ll have to take 5 tablets at once,because of my weight 74.2 Kg and she didn’t even ask if whether I’ve gain or loose weight,and I’ve been on that same weight for years now.
I’m confused cause I thought I was going to consume only one tablet a day,my question is,is the instructions from the nurse correct,is 5 tablets a day at once not too much
Hi Deepack,
What ARVs are you taking? Why have you been told to take isoniazed? How long have you been on meds? What side effects are you know having?
I have HIV I am under ART. treatment my CD4 count is 538 currently but my doctor recommended me is isoniazed tablets after taking these tablets I felt very weak too tired I can’t even stand abdomen pain feet swelling I’ve stopped taking those tablets now the side effects are getting worse please help .
Hi Xolile,
It sounds like you may be taking meds that contain efavirenz. If you are then you may need to change. Please see Q3 here:
http://i-base.info/qa/what-are-the-most-asked-questions
No one can make you take medication.However, we now know that its better to be on meds, than not be on them. This is due to the findings from the START study:
http://i-base.info/i-base-qa-on-the-start-study-results/
From 2007 I found that I’m hiv positive..I started ARVs this year March 2017 and they give me prophylaxis isonaizod I feel terrible I can’t study ,I’m always have suicidal thoughts ,nausea and vomiting,blind vision,mood swings..easily irritated ,numbness,when I’m concentrating to something I become drowsy ,I’m always dizzy, I really need help.. my CD4 it was 645 the time I start this medication..can I stop taking Prophylaxis..?
Hi Zee,
In areas where TB is prevalent, its common for people with HIV to also have TB. It can though be treated, so you should try not to worry too much about having this co-infection. There’s more about it here:
http://i-base.info/qa/5419
Other than the rifafour are you going to be given anything else?
Also, just so you know its very possible to take both ARVs and TB meds at the same time.
I started ARVs last year in July, with a CD4 count of 179. Ever since then my health condition has been terrible. Last week when I went to the clinic I tested positive for TB. I’m going to start rifafour, I’m so scared.
Hi Phindile,
How TB is transmitted is discussed here:
http://www.tbfacts.org/tb/
I’ve been taking ARVs for 7 months, I just find out that my partner has TB, is possible for me to get infected with TB through him?
Hi Hlengiwe,
If they’ve said come back after two weeks, there must be a reason for this. When will you get your CD4 results?