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CD4 count @ 11: is Triomune recommended?
Feb 13, 2010

I'm turning 28 next month & been infected with HIV for 11years. I've been healthy & still look healthy even now without medication but i just got results that my CD4 count is now 11. I'm scared & shocked coz I look good & work HARD to maintain my weight as i gain quite easily. My doctor said he'd give me Triomune but i just want to know if it's safe since my count is so low now.

Response from Dr. Young

Hello and thank you for your post.

Your case raises a couple of very important points. First, just because one looks and feels ok doesn't mean that your immune health is good. This is precisely why we recommend regular (at least every 6 months, preferably every 3-4 month) clinical and laboratory evaluation.

If your CD4 count is really (confirmed) at 11, you have very seriously impaired immune function and AIDS. You should be starting among other things, HIV treatment as soon as possible (but after a complete evaluation for the presence of other health conditions, such as hepatitis or tuberculosis). You should also be started on an antibiotic medication (trimethoprim-sulfa; Bactrim, Cotrimoxazole) to prevent the serious AIDS complications, Pneumocystis and Toxoplasmosis.

Triomune (d4T, 3TC and nevirapine) is widely used as a first-line treatment in developing countries, but because of increased risk of toxicities, the use of d4T has been discouraged by the most recent guidelines from the World Health Organization (for developing countries) and has long been abandoned by the US and European guidelines. The use of nevirapine is generally safe, so long as you don't have active liver problems (or have a CD4 count greater than 250 (for women) or 400 (for men)). All of that said, if the only HIV treatment available to you is Triomune, it's far better to initiate Triomune than to leave one's self at risk of AIDS complications.

I hope that you find this helpful; please write back with any follow up questions. BY



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