Q Dear Doctor, My brother has been on ARVs since 2011 when his CD4 count was at 84 cells/ml. However, we just discovered that he no longer takes his drugs. He claims to be well after being prayed for.
His CD4 count was last taken six months ago and it was at 350 cells/ml.
We have convinced him to resume taking his drugs, but does that mean he should carry on with the old ones, or he should take second line drugs, which are stronger?
A Dear Jimmy,
When people living with HIV (PLHIV) are being prepared for antiretroviral therapy (ART), issues of compliance and adherence are stressed.
They are also helped to know that although they will improve once they start taking ARVs, they must continue taking them because ARVs do not cure HIV.
ART is treatment for life. Although we encourage use of treatment supporters for people staring to take ARVs, PLHIV must be trained in selfmanagement and motivated to take their drugs regularly, regardless of what they hear from time to time from other people such as faith healers and others who may not know or understand how ARVs work.
Uganda has over 500,000 PLHIV who are on ARVs.
When we put all our PLHIV on the drugs following the current World Health Organisation guidelines, which stipulates that everyone with a CD4 count of 500 cells/ml and below should be on ARVs, we shall have over one million people taking ARVs nationwide.
We must, therefore, promote HIV treatment literacy for all, so that all those on ARVs take them with good adherence.
This way, we shall be able to suppress what could be referred to, as the “community viral load” or amount of HIV in the community.
This will also help us reduce new HIV infections on top of stopping AIDS-related deaths among PLHIV.
Lastly, your brother needs not start on second line drugs, since there is no evidence that he failed on the fi rst line ARVs.
He should go back to his old regimen and make sure he takes all his drugs as prescribed by the doctor.