We're afraid she might forget to take her ARVs

Aug 23, 2016

Her CD4 count is 35 cells/ml and we have been told she should start taking ARVs but we are worried.

Dear doctor, we have just discovered that our sister is HIV positive and now she is very sick. She is confused and seems to be losing her memory.  She often mixes our names and yet we are her siblings.

Her CD4 count is 35 cells/ml and we have been told she should start taking ARVs but we are worried.

How will a person who is so forgetful be able to take drugs daily? Is there anything she can use to improve her memory before she starts taking ARVs?

Sylvia.

Answer

Dear Sylvia, it is a pity you discovered your sister's illness when she is very sick. Treating HIV is similar to repairing a tear in a piece of cloth and the earlier you do it the better.

That is why we encourage all people to regularly check for HIV and for those who test HIV positive to seek care and treatment as soon as possible.

Your sister's mental problems, including memory loss could be as a result of the effects of HIV on the brain. It is recommended that such people should be put on treatment with ARVs as soon as possible but under supervision.

Many of them improve once they are put on ARVs.  On the other hand, mental confusion can be a result of opportunistic diseases like meningitis or toxoplasmosis, which tend to attack people with such low CD4 counts.

 So, what can help is putting her on ARVs but the drugs should be kept away from her and given to her to swallow under supervision.

This is known as directly observed therapy, which is useful for people who may not be able to adhere well on their own.

When her memory improves, then she can be counseled on the importance of adherence if treatment with ARVs is to succeed.

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