Question
How long will my wife need to take ARVs?
14 February 2012. Related: Adherence, All topics, Pregnancy, Resistance.
Hi doctor.
I tested HIV positive 3 yrs ago together with my wife. I took septrin for 2months before I stopped. From the onset I took CD4 count and it was 465; the 2nd was 543; the 3rd was 650; the 4th was 770; the 5th was 861 and the last one I took two weeks ago was 940. The same case my wife who now has 897 up from 360.
She is on ARVS because we are trying to concieve. My question is, what are the risks of my wife stopping taking the ARVS? Or for how long will she take the Arvs?
We have not been using any protection. What are the risks?
Answer
Firstly, I would like to confirm that we are HIV positive treatment advocates, and not doctors.
You have asked a number of questions so I will try and answer them one a time.
Your first question is what the risk to your wife if she stops taking her ARVs. Without treatment your wife’s CD4 count is likely to drop back to where it was before she started and to continue dropping. If her CD4 count drops to 200 cells or less, she may be at risk of developing opportunistic infections. These are infections such as pneumonia, which a person can get when they have a weak immune system.
Your second question is how long she will need to take the ARVs. Both European and WHO (World Health Organisation) treatment guidelines recommend starting when you have a CD4 count of 350. This is close to what your wife’s CD4 count was when she started. The aim of treatment is to maintain a good CD4 count (above 350) and to reduce the amount of virus in your body. This is referred to as having an undetectable viral load. Your wife will therefore need to continue taking the treatment for life. Having a good CD4 count and an undetectable viral load will enable her to stay well for many years.
Your third question was regarding what the risks are if you don’t use protection as you are trying to conceive. Many HIV positive choose not to use condoms for protection. The main risk involved is if one of you has resistance to 1 or more HIV treatments. This is another reason why your wife should not stop taking ARVs. She will therefore need to take her medication exactly as advised and not miss any doses. This is to prevent her from becoming resistant to her current medication and risk passing on the resistance on to you. For more information on resistance, please follow this link to our guide.
Another risk of not using condoms is getting STIs [Sexually transmitted infections]. A further issue could be being re-infected with another strain of HIV. The HIV which one person has is not always the same type(strain) as another person. However, without knowing the full details around your circumstances, it is not possible to know if this will be an issue for you.
Generally, if neither of you have resistance or STIs, then there should be not problem with having unprotected sex. The key thing to note though is that if your wife does become pregnant, the recommendation is to use condoms. This is in order to minimise the risk of transmitting HIV to the baby. For more information on HIV, pregnancy and women’s health please follow this link to our guide
Best wishes
Hi Imelda,
Try not to worry, it is unlikely that missing two days of treatment will cause you a problem. You would have to be very unlucky to develop resistance from this one-off. Do speak to your doctor about this at your next appointment, but try not to worry.
Hi i missed taking my ARV for two days anf am frantic, this has never happened before. i,ve been on meds for 5 years please help. what are the risk i face as i am very worried.
Hi
If you are both positive and both not on treatment, then you only need to use condoms if you need protection against some other sexually transmitted infections or as birth control. If you want to become pregnant, then doctor to your doctor. You don;t need to start treatment to become pregnant, although some people do this, but you will need to using treatment during pregnancy to reduce the risk of transmitting HIV to your baby.
See the i-Base pregnancy guide:
http://i-base.info/guides/pregnancy
Especially this section on when both partners are positive:
http://i-base.info/guides/pregnancy/both-hiv-positive
Me and and my husband are both HIV Positive and are on ARV’s so does it matter if we have unprotected sex? and for how do we have to take ARV’s so that we can start getting pregnant
Hi Zandile,
I’m sorry to hear about the problems you had taking treatment in the past. The aim of treatment is to increase the CD4 count, but also to decrease the viral load. If your viral load was staying high this means that the combination you were taking either wasn’t strong enough, or you may have had resistance.
Since you stopped treatment have you been to your clinic for monitoring? It’s important to get your CD4 count and viral load checked, even though you’re not on treatment right now. This is a good way of checking how you are getting on.
When you are ready to start treatment again you will need to speak to your doctor about what you were taking in the past, and your test results. If you did have some resistance to one of the drugs you were taking before you may not be able to take this again. But this isn’t a reason to panic. There are lots of different HIV drugs available so it is very likely that there will be a good combination available that will work for you.
Can I ask which country you live in, and if you have any support?
Hi, I was tested HIV + in 2003, I started taking ARV’s in 2008. My viral load was forever increasing so as my CD4 count. This stressed me a lot, in such a way that, when I was suppose to go for my last regime, I thought no. My kids are still very young for me to die. I called it quits. I stopped in 2010. Now I want to know what will happen to me if I restart my treatment? Thank you.
Hi Sam,
I’m sorry to hear how worried you are. Can I ask which country you live in? And also how your health is generally?
Unfortunately not every country has access to the tests which we use in the UK to monitor HIV. Most countries do have access to CD4 count testing though, and this can be used to check how well treatment is working. When was the last time you had this checked?
If you are taking your meds properly then they should keep working. Usually treatment only stops working if you get resistance, and this is usually caused by missing doses.
Hi,
I’ve been on ARV drugs since 2008. My CD4 count was never check bfore been placed on the drug. However, I noticed that it was way below normal considering my condition at the time. Have improved greatly since, though.
My concern is the future. Have been on the combination of Lamivudine, Nevirapine and Zidovudine for these time. Have been regular (99%) in taking my drug for all these times. Just that in my country there have not been day in which I was subject to any test to know if things were working well. This has been due to inadequate programs on HIV/AIDS in my country.
I have in the past time used visual test by myself, looking over my physique, weighing myself frequently and other stuff. But sometimes I just get that funny feelings that I am losing it.
I am doing this all alone, and really need advise so as to keep myself going.
Kindly advice.
Thanks
Hi Jonathan,
HIV treatment is very effective, even when your CD4 count is this low. Life expectancy is different for everybody and depends on other health conditions as well as HIV. But so long as you do well on treatment you can hope to live for many years.
I have just started taking arvs and my cd4 count was 8,I would like to plan wisely for my child who is 5 years,how long can i live?