Someone asked me

Good morning. In February 2018 I was diagnosed with HIV + with CD4 only 190. At that time my bb dropped drastically from 92 to 84. In September 2018, I did an examination 6 months after ARV therapy and cotrimoxazole taken regularly every day. The result is that my CD4 is now increasing to 486 and my Viral Load is <40 (what exact number is not written). And my bb has now risen back to 97kg. Normal SGPT results 25. My questions: 1. I was sent to the nurse, when taking ARVs at the hospital. According to him, I was able to stop taking Cotrimoxazole. Is it correct doc? I am worried if CD4 stops coming down again. 2. The 5th month, doctors advised me to take Isoniazid and Vit B6. Do you need to continue the dock? 2. In the lab results, my VL is <40, does that mean it is not detected? If one day I get married, my wife is safe from HIV from me? The thing that I feel right now is after 6 months of ARV and cotrimoxazole. I feel healthy and fit. Exercise 3 times a week.

Answer from me

Thank you for the question.

Human immunodeficiency virus (HIV) is a virus that attacks the human immune system so that the body of the sufferer is unable to cope with infection or other diseases. Therefore, people with HIV are very susceptible to infection or other diseases. Co-trimoxazole is a combination of two fixed dose antibiotics (sulfamethoxazole and trimethoprim) which can overcome various bacterial, fungal and parasitic infections. This antibiotic is recommended for HIV positive patients to prevent infection and reduce morbidity and mortality / mortality associated with HIV infection.

This drug is recommended for adults (including pregnant women) with severe or advanced HIV clinical disease (stage 3 or 4) and / or with a CD4 count of 50350 cells / mm3. In general, this drug can be stopped if the patient has stable clinical symptoms with the use of anti-retroviral drugs (ART), with evidence of immune recovery and decreased number of viruses. Do you know why you are taking isoniazid? Isoniazid is one of the anti-tuberculosis drugs (OAT). Does the doctor tell you that you have tuberculosis or is the use of this drug only as a prevention / prophylaxis against tuberculosis? People with HIV who also experience tuberculosis are advised to continue to take co-trimoxazole without seeing CD4 results. Therefore, you should consult with a doctor who handles you before stopping the two drugs because the doctor can determine the treatment you should take after examining you and after knowing the results of your laboratory examination.

Viral load is an examination to determine HIV particles in 1 milliliter of blood. This examination is intended to assess the severity of HIV infection and monitor the effectiveness of treatment to control HIV. A viral load below 40 indicates a very low number of HIV particles in the blood, which may not be detected. However, this does not indicate that you are cured of HIV infection. One of the transmission of HIV is by unprotected sexual intercourse (condoms). The risk of a woman being infected with HIV from you is much reduced if you have a low or undetectable viral load. However, you should still discuss this with your future spouse.

Please always consult with the doctor who handles you (not other medical personnel) because the doctor has examined you and knows your condition.

Hopefully this information is useful.