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cd4
Apr 18, 2013

i am 40 years my cd4=13 with hcv positive how much time i have which med u recommmend now i use 2 lamivduodine & zidovudine daily+2 tablets(12hr) +2 nevirapine200mg 2tablets daily(12hr) +2cotrimasazol daily(12hr)

Response from Dr. Young

Hello and thanks for posting.

From the names of your medicines, I can deduce that you don't live in the US. The medications that your taking are among standard first line regimens in many resource-limited countries and should suppress the HIV in your body and allow the healing of your immune system.

Nevirapine should be used with caution in people who are living with HCV (though just because your antibody tests are positive for HCV doesn't mean that you have active HCV), since a characteristic toxicity of nevirapine is liver-related.

The cotrimoxaxole is highly recommended for all people living with HIV and whose counts are below 200-- for prevention of Pneumocystis pneumonia and toxoplamosis brain infection.

If you don't have any other active medical complications or opportunistic infections and you're able to stay adherent to your medications, I'd think that your prognosis can be excellent. Indeed, once you achieve an undetectable viral load (if it's done where you live) and a normal CD4 cell count, your health risks from HIV are much reduced.

I hope that is helpful. Be well, BY

Response from Dr. Taylor

If possible, it would be helpful to find out if you have hepatitis C or not, although your HIV is first priority. I am glad that you have started HIV medications, this is most important. I strongly suggest continuing.

The next blood test to determine if you have hepatitis C or not, is the hepatitis C RNA, or viral load. There is about a 15% chance that your body got rid of hepatitis C on its own, and about an 85% chance that you have this infection.

Nevirapine is safe and effective in most cases. Rarely there have been concerning reactions involving the liver, and the risk can be higher for people with hepatitis C. Therefore if possible it is helpful to monitor liver blood tests during the first 18 weeks of therapy. Your risk sounds LOW as the risk is higher at higher CD4+ cell counts. Women have greater risk than people of other genders. Let your doctor or nurse know if you develop a rash, which can be an early warning sign.

Again, overall, the best thing is to take these HIV medications. Getting your HIV under the best control possible is good for your HIV-related health, and in the event that you have hepatitis C.

I wish you the very best.



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