Email 381: Can We Take ARV's Now?

Posted by Pozziepinoy on 8:26 AM

Hi Pozzie,

Just to refresh the story I have a bf who is diagnosed with HIV last year of August. I came home from XXX on the month of March 2013 to get myself tested and we are very thankful that I did not got infected :)

My doctor in Manila Medical Center advised my bf to start treatment even if his first CD-4 count is 380 as per our understanding from my bf's doctor in his hub at Pampanga there must be a certain no. of cd4 before he undergoes treatment. My doctor at Manila Medical Center told us that there is a new protocol wherein if one of the partner is positive and the other is negative. The positive partner can start treatment earlier in order to get a higher count as fast as possible. To cut the story short he shouldn't wait for his count to reach the limit before starting his treatment.

We badly need your advice. My bf went to his hub for his 2nd CD4 count today and he discussed the new protocol that my doctor in Manila Medical Center advised us to follow. Unfortunately, his doctor wouldn't advise such, he said that the ARV's may cause side-effects that his body might not be ready for because his count is does not require treatments yet. Plus the dosage of ARV's gets higher and higher so the doctor is not sure if this is the right thing to do but if we insist he can start his treatment as soon as possible.

We are now confused whether to follow my doctor's advice or his doctor's advise :( How true is it that there are side-effects on taking ARV's and how bad does this side-effect gets to one HIV positive person. We are hoping that you can help us on this Pozzie. Thank you.

XXX


POZZIEPINOY'S REPSONSE

Hi XXX.

Thank you again for your email.

Let me answer you question in the order that you asked them.

First, with regards to ARV prescription, it is true that worldwide, the protocol is to provide ARV's to an HIV positive individual as early as possible to prevent the collapse of the immune system, irregardless of the CD4 count.

However, in the Philippines, since we are beneficiaries of grants from the Global Fund, we don't follow this. The ARV's are expensive and would cost one around $2000 for a cocktail per month and I am personally happy that we are getting all our medicines here for free. However, the policy of the Department of Health is to give the free medicines to PLHIV's who have CD4 counts of 350 and below only since the grant that is being provided for the medicines is not enough for everybody (if every PLHIV, even with CD4 higher that 350). That is under stable. 

My suggestion is to follow the regulations of the hubs and just monitor the CD4 count of your bf every 6 months and follow what the doctor tells you guys to do on how to increase his CD4. Unless of course you can purchase out of your pocket the ARV's that will be prescribed, then that will be a different matter. For now, like what I always tell my readers, "beggars can't be chosers", unless of course the grant for PLHIV's for the Philippines will be increased by the Global Fund, which is another different matter.

You pointed out in the email that the doctor mentioned that the dosage of ARV's will get higher and higher. I believed there was a misunderstanding about this as this is not true. The ARV dosage remains the same for life (until a cure has been discovered)!

With regards to the side effects of ARV's, each individual is unique and each one has a different reaction to the ARV's. That is the reason why there is a trial period of 2 weeks of taking the ARV's. This is the window period for all side effects to show up. Aside from that, once on ARV's every 6 months, one is required by the hubs to take the CD4 count to check if there is improvement with the immune system, and a yearly blood workout and viral load count to assess the health status of the individual. This means regular check ups of an HIV person!

Once again, thank you for your email and wishing all the best for you guys.

Stay healthy,
Pozziepinoy




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