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.
On march 2018 i got sick of flu,lost weight then skin rash followed. I then decided to visit the doctor, got treatment & it worked good, then my weight was back to normal. After all i decided to went for blood test & the results were positive & TB &cancer tests followed, came out negetive. But they gave me what they call TB prevention treatment in different two types & ARVs and advised me to take them together same time. Still today am on that treatment and am fine.
Hi Natasha,
What ARVs are you taking? Are you taking Atroiza or Tribuss or any of the other names for these drugs listed here? A reported side effect of these is feeling dizzy, especially if you take it during the daytime.
It’s recommended that you take these before bedtime. Taking the pill at night reduces these side effects as you will be sleeping when drug levels are highest. A high fat meal can increase drug levels but other food is okay.
But Winthrop Isoniazid can also have side effects. It’s a good idea to talk to your doctor about this and discuss what drug could be making you feel dizzy.
On the 18th of April 2018 I tested positive for HIV. When I went for blood tests two weeks after, before starting the treatment, my CD4 was 476. On the same day they gave me winthrop Isoniazid 300 mg to prevent TB as well as pryxodine. The following week i started ARVs. I have been feeling dizzy and tired. How best to take my meds in order to not feel dizzy because as a student i am unable to concentrate?
Hi TC,
Do you live in an area where TB is prevalent, if you do this will explain why you’ve been given TB meds.
Its safe to take both TB meds and ARVs at the same time.
HI DOC
I found that i am HIV positive in April 2018 and started treatment right away. my CD4 count was 640 and last week i got flu cause is now winter, i went to clinik and they give me Nucotrim tablets. that is means i got TB? i never skip my ARV treatment
Hi Nozie,
TB meds can be given to people as a precautionary measure if they live in an area where TB is prevalent and if their CD4 count is low. Is this your position?
Is it necessary to take Tb tablets and Arvs when not diagnosed with TB
Hi Mason, Can you check with the clinic about your treatment? We are not doctors so it’s important that you talk to the doctor to find out about the meds.
Hi lisa, please i went to the clinic today to collect my arvs and cotrimoxazole and i was also given isoniazid for 6 months .now am worried wether is okay to take the two antibiotics Together beacuse no TB test was carried out on me and i havnt checked my cd4 count recently and have also being on arvs for nearly two yrs with no health challenge apart from the normal side effects of efavirenz. Will be grateful if i get a reply.
Hi Hippopa,
What ARVs are you taking? What was your CD4 count when you started meds? Other than the Rifafour that you’ve been given are you taking anything else?
With regards to the Rifafour as the following explains the dosage goes on weight. For your weight, 5 tablets daily is normal:
http://home.intekom.com/pharm/hmr/rifaf275.html