Email 662: When to Stop the Prophylaxes?

Hi Pozzie,

In your earlier blog, I saw you wrote this?

"But what she started telling was so amazing that I almost jumped for joy. She told me that as soon as I reach my 6th month, I won't be experiencing any hiv related illnesses as long as I continue my ARV's. She told me that she would be removing my cotri and azithro as soon as I get my CD4. She also told me that even though the CD4 would still be low, it doesn't matter anymore because I am i perfect health right now. My body recovered fast, 

she said. She then said that I am "normal" now. I am so happy."

Is this true? My HIV doc never told me this. And based on all my readings, I read that a certain CD4 has to be reached before you could stop your prophylaxes. This is very exciting though. Why am I asking... it's just for additional peace of mind. Of course if my HIV doc tells me to continue my prophylaxis even after 6 months, I would follow her 100% .

XXX 

POZZIEPINOY'S RESPONSE

Hi XXX.

Thank you for your email.

You quoted me from a previous blog entry that was written when I was still sick. My ID doctor then was so optimistic that she was implying that by 6 months, with my fast recovery, I would be weaned of the prophylaxes which was really true.

However, you are right that the CD4 is the basis on whether to stop both the cotrimoxazole and the azithromycin, the prophylaxes against opportunistic infections for people with CD4 below 200 (AIDS level). When one reaches the CD4 of above 200 (or 250 depending on the doctor), the prophylaxes will be discontinued. In the Philippines, because CD4 is prescribed every 6 months, that time frame is the deciding factor. In my case, from 70+, my CD4 jumped up to 400++ in just 6 months and my prophylaxes were stopped. My doctor predicted it accurately.

From my experience in dealing with a lot of PLHIV's, 50% of the cases are still continuing their prophylaxes beyond 6 months because their CD4 counts are still below 250, irregardless of the physical health status. 

My advice is to keep on boosting your immune system and try not to get sick so that after 6 months of ARV's, your CD4 count will jump up and eventually you would stop taking both prophylaxes which is quite costly.

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

Stay healthy,

Pozziepinoy

"WE ARE ALL IN THIS TOGETHER.

NO PLHIV is alone with his or her struggle with HIV!"

-Pozziepinoy-

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