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, Southern 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 Deee, yes you can.
Can I circumcise when I have just began taking ARVs
Hi Nozzy, I am sorry to hear that you are experiencing these effects. What ARVs are you taking? and for how long have you been on them? Often side effects are worse when starting and hopefully they will lessen as your body gets used to them. I understand that you would have been feeling well before starting medication however, if you are not on medication HIV is not being managed. You may not feel the effects but HIV will reduce how well your immune system functions and eventually there will be problems with your health. ARVs need to work for you but getting used to them can be difficult. ARVs really are the best way to keep a healthy life. Have you been able to speak to a doctor about the side effects you are experiencing?
Hi
I’m 28 yrs old…I ve recently started arvs but da issue I have these tablets re making me dizzy, nauseous, n very weak.. is it owk if I can just stop coz I wasn’t sick before starting it
Hi Sandra
Does your doctor know about your medicine times and appetite problem?
Are you getting up at 4 am just to take the TB meds? Or is this the normal time you wake up? Although these meds should be taken on an empty stomach, you can eat an hour later if you want.
Do you know the names of your HIV meds? I assume these maybe include efavirenz, if you are taking them at night. If the nausea is from the medicine, your doctor might be able to help. Also, did they say how long you need to take the TB meds for?
Sorry for all these questions – the main one though is if your doctor knows about your difficulties.
Im am taking my winthrop,pyridoxine and novatrim at 4oclock in the morning before my breakfast and taking my Arv at 8oclock every night,but i’ve noticed that i dont have appetite at all,im eating fruit and biltong only that’s all i can eat,im getting neusea when i eat something else.is it the right thing
Hi Betty, thanks for yor questions. Finding out you are HIV positive can be difficult. You are lucky though to have found out before your CD4 count went even lower. ARVs are very effective and will help your CD4 count to become stronger again. Nucotrim contains two antibiotics (trimethoprim and sulphamethoxazole) that will help protect you from other infections. Izoniazid is also recommended to protect you against TB while your CD4 count is low. This is very common is countries where there is a high risk of TB. Please talk to your doctor about your worry. They will be able to explain why all three medicines are recommended. Even though you don’t have TB, the same meds are used to prevent TB.
Hi, I tested hiv positive and my cd4 is 78. So I started treatment and the clinic gave me isoniazid. I didn’t take this because I do not have TB. MY questions is if this a a risk or what? Must I take this medication. I only take Nucotrim and my ARVs.