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Diagnosed with HIV and TB. Taking ZLE and DOTS. How to lead a healthy life?

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General & Family Physician
Practicing since : 2005
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I am a housewife with two kids aged at 33 lives in india. Recently diagnosed with HIV & CD4 counts are just 60 & started taking ZLN. After 15 days diagnosed with TB also. Now having ZLE & DOTS medicine from GH.
KIndly advice me on :
1] How long I live?
2] Will there any side effects of theses medicine?
3] If so, how to overcome?
4] What are all the eating habits, life styale changes I need to make?
5] Is thaere any other way to lead a long & healthier life?
Posted Fri, 7 Dec 2012 in HIV and AIDS
Answered by Dr. Shanthi.E 3 hours later

Thanks for posting your query.

I see that you have tested positive for HIV recently with a CD4+ count of 60. I am sorry that you are suffering from TB as well. I am glad that you have started the anti-retroviral treatment as well as the anti- TB treatment.

Please do not say that your CD4+ count is ‘just’ 60. With effective treatment and with good compliance from the patient, CD4+ count will eventually increase. This is because as the viral load decreases with the anti-retroviral treatment, the CD4+ count will increase. This has been proven by well-documented studies.

Coming to answers to your queries:

1. You would live longer. There is no specific answer for this. Death could be due to accident, heart attack, homicide, suicide. HIV may not actually be the cause of death. My point is - No doctor will ever predict a patient's longevity.

An example: A documented study shows that persons with CD4+ count of 11 at the time of initiation of treatment showed a drastic improvement in the same levels at more than 200, after completing 24 months of treatment.

2. There are adverse side effects of the drugs that you are on. You may be experiencing it definitely by now. Liver dysfunction and jaundice, bone marrow depression, neuropathy, loss of weight, nausea and indigestion are common side effects.

However, the benefit from the treatment is more than the risks associated. My suggestion for you is to continue the treatment.

3. You need to take the regular course of multivitamin supplements to reduce these. Specific symptoms may be managed by your primary treating doctor at the GH as and when they arise.

4. You need to take a diet XXXXXXX in proteins and energy as well. Include a whole egg in your diet daily, a glass of milk, lots of spinach, and pulses and nuts, almonds and olives as well.

5. Eating nutritious food, continuing the treatment regularly, mild to moderate physical activity every day, a peaceful and positive mind can help you in leading a long and healthy life.

In my clinical practice, I have many people with HIV infection who were diagnosed with HIV, 10 to 15 years back and are currently in excellent health and they continue to do so.

You have a long way to go and only you can live your life to the fullest and to the maximum.

You are on the right path. Follow your doctor's suggestion.

Let me know if you have more concerns. Keep me posted at this link.
All the best.

Take care!

Above answer was peer-reviewed by
Follow-up: Diagnosed with HIV and TB. Taking ZLE and DOTS. How to lead a healthy life? 8 days later
Doctor, This is regarding the adverse side effects of medicines, I am facing now.

1] I Was experiencing earlier while starting treatment & improved rightnow :

Initially I was suffering from severe headache. Now I am O.k.
Was having lesser food. Now somewhat improved.
Ear pain - Now it is o.k.
Heavy fever frequently. Now o.k.

2] Was experiencing earlier & still persists :

Severe tiredness.
Lower hearing ability.

3] Recent problems:

Lower voice - afraid that I may become deaf & dump.
pre mensuration - in just 16 days.
Having leg pain 6 inches above my right side toes of the backside of right side leg. Now pain is becoming severe specially when I walk. [What could be the reason? Nueropathy/bone marrow depression.

What is the reason for all these? How to overcome? Kindly advice anything serious? Whom to consult apart from GH doctor?[weather neuro doctor or physiotherapist or general physician}.

I am deeply worried. Doctor said Everything will become normal within 1 month. But already 1 month is going to over & I am suffering too much. As a result my husband has also resigned his job & lost his hope on life[me too]. Kindly advice us on this critical time. We may choose to decide something serious i.e., committing suicide along with children. Help us.

Answered by Dr. Shanthi.E 43 minutes later

Good to hear from you again, but sorry to hear the wrong, negative thought process that is going on in your mind.

Let me tell you one thing, your lifespan is already reduced due to the HIV positive status. Why do you want to further shorten it by committing suicide? We all get to live only once, please try to live a good quality life now rather than thinking about the lifespan, the HIV infection and the medications.

Please remember it is the quality and not the length of time that you live, that matters.

Coming to your current problems:

1) I am glad that there is so much improvement in your symptoms. Smile!!, there is so much improvement in your general health. You are able to eat better, less fever, fewer headaches, less earache.

2) Severe tiredness is probably due the effects of the anti- tubercular and anti-retroviral medications that you are on. The low hearing ability is probably because of a sensorineural hearing loss due to HIV infection by itself. A complete audiogram can help us in finding the exact cause and manage accordingly.

3) Lower voice may be due to pharyngeal wall (Throat) irritation due to inflammation. You may have irregular and frequent menstruation due to Tuberculosis per se. The pain in your leg seems more like due to Neuropathy and not due to bone marrow depression.

The reasons for all these is because of the interaction between the dying virus and the raising CD4+ count in your blood. It is a good sign overall excepting the low hearing.

How to overcome? - You should be taking B-complex group of vitamins by now on a daily basis. If not, start them right away. A single capsule of Multivitamin every day will solve most of your problems. I hope you are following the diet that I mentioned in my initial reply.

Nothing is serious; you are doing very well right now. Consult an ENT specialist who can do an Audiogram and treat you accordingly. And, follow up with your General Physician. There is no need to consult Neurologist at this point.

You already know the cause for all these. Stop worrying about the future; try to live your everyday with XXXXXXX happiness and peace. Please take it ONE DAY AT A TIME.

You will do well soon. Keep me posted.

Take care.
Above answer was peer-reviewed by
Follow-up: Diagnosed with HIV and TB. Taking ZLE and DOTS. How to lead a healthy life? 17 hours later
Thanks a lot doctor.
Answered by Dr. Shanthi.E 21 minutes later
Thank you too.

If you are satisfied with the answer, please close this discussion and write a review.

You can write back to me at this link in future, if in need.

Take care!
Above answer was peer-reviewed by
Follow-up: Diagnosed with HIV and TB. Taking ZLE and DOTS. How to lead a healthy life? 2 days later
Sorry doctor,

I am facing one more problem. My skin in the hand & leg fingers are shrinking & becoming dark or block colour compare to my red colour skin in the body. There is no change still. Will it flourish again? how long it will take? Is there any natural remedy for this? why it is like this? Can you recommend any food to be taken? or is there any tablet? Please guide me.
Answered by Dr. Shanthi.E 24 hours later

Pleased to write back...

Skin and nail changes is most likely the effects of your general condition. Are you eating well and drinking enough water?

Medications given to you may not be contributing to the skin effects; however other causes such as skin infections (fungal) / nutritional deficiency need to be ruled out too. Have you seen your treating doctor?

In all probabilities, I do not think this is something serious and it should improve with good protein XXXXXXX food and plenty of fruits and vegetables. Drinking plenty of water to improve body hydration will also improve your skin texture and colour. Please consider your diet and water intake seriously in addition to the medications. I also urge you to follow up with your treating doctor if you last saw him/her a while ago. He/she can rule out other specific nutritional deficiency / infection. I hope you started the multivitamin pills as suggested in my previous reply. You may continue it for added benefits.

I understand you are concerned and probably depressed too; but keep up the good hope. Things will not improve drastically with this infection, but there is definitely a XXXXXXX of hope. Apart from healthy and nutritious food, plenty of water and regular medications, we do not have any other remedies.

You will feel better. Stay positive. You can write back to me for any other assistance if needed.

Best Regards

Above answer was peer-reviewed by
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