Living with HIV in the Philippines: Email 593: HIV, the Common Cold and ARV's

Pozzie,

good day.

its me again, unprecedenteed (email 574, sept, 2013). its been confirmed, i have hiv. the doctor told me that i don't need yet to undergo treatment because my cd4 is still above 500. treatment of hiv is quite expensive maybe that's the reason why they gave digits for the people to be treated and not to be treated yet? my concern now is that once we are diagnosed with hiv+ whatever our cd4 count is, we should be treated right away (is it correct?). i don't have money because i don't have work now. i am sick almost everyday, my colds won't subside it's accompanied by headache that's why i'm asking these questions. what should i do?

hope you can help me.

yours truly,

unprecedenteed

POZZIEPINOY’S RESPONSE

Hi unprecedenteed.

Thank you for your email. Thank you for sharing us your concerns.

I know you are worried about your health, however since your CD4 is still high, you can consider any over the counter medications and do conservative treatment for your cold as well. Here in the country, many have colds and flu because it has been raining almost everyday now so anybody even PLHIV's can also be affected by them.

Taking ARV's doesn't mean that you won't get sick anymore. We are all humans and definitely we can get all kinds of infections if we are not careful. All we need to do is always take the necessary precautions and if indeed we get sick, take the necessary action. In your case, since you have a cold, just treat it conservatively. Drink a lot of water, take paracetamol if you have a headache and rest which is your privilege since you are not working. To calm down your nerves, I have been down with cough, cold and fever for almost a week now. As you all know, my CD4 is way above 500 too, on ARV's with undetectable VL. My doctor, Dr. Ditangco said I'll be fine and just try any over the counter cold and fever relief. Because it wasn't showing improvement that fast, I went to see my pulmonologist with my chest Xray at hand and he said it is just the common cold and prescribed me with some other medicines.

Regarding your concern that all PLHIV's irregardless of their CD4 counts should be given ARV's as soon possible, I totally agree with you because that is the trend now in the treatment of HIV. However, it is still based on how a country can afford to dispense these medicines. In the first world countries, mostly the insurance companies pay for the ARV's (which the PLHIV's pay on a monthly basis, FYI). Some can afford to pay for the ARV's, thus they can get treatment fast. In developing countries wherein the governments can't afford the ARV's, they just rely on grants from foundations for these ARV's and try to control the distribution of these medicines.

Since our ARV's are just a part of a limited grant by the Global Fund given to the Philippine government for PLHIV's and not available for sale in the country's local pharmacies, we all can't benefit from it except for those who need the medicines the most. The criteria for qualification to ARV treatment that is being used here is the CD4 count of 350 and below since at that level, a PLHIV's immune system can spiral down to AIDS levels (CD4 of 200 and below). The rest of the PLHIV's with CD4 of 351 and above are made to wait until the next schedule of CD4 testing. The HIV doctors, since they are not in control of the ruling by the DOH, will give techniques and advices on how to boost the immune system of a PLHIV.

I have received some violent reactions about this, but like what I said, "beggars can't be choosers". Our government can't afford the expensive ARV's so we have to follow what the guidelines are for now. On my end, let us just be grateful that the ARV's are being given for FREE, and for being dispensed to those who are in critical levels.

Unprecedenteed, just get well, and if you think you are not getting better, then go seek consult from a doctor. Your CD4 is high enough so it is not the HIV that is causing it but another infection. Dr. Ditangco said to me before that people always blame the HIV even though it is not really the cause of their infection. She also said that HIV treatment is different from treatment of other infections so if one is sick, just go and get treatment.

I hope I was able to answer your concerns. Feel free to email me again if you have other questions.

Stay healthy,

Pozziepinoy