Question
Is cotrimoxazole recommended during pregnancy for women living with HIV?
19 July 2015. Related: All topics, Opportunistic infections, Pregnancy.
When is cotrimoxazole contraindicated (not recommended), in a pregnant HIV-positive woman, with a CD4 less than 200 cells/mm3?
Answer
Yes.
WHO guidelines recommend using co-trimoxazole during pregnancy, just as they would for a woman living with HIV who is not pregnant.
The main concern is only if someone was allergic to this drug (or class of drug).
This means that cotrimoxazole is recommended for the mother’s health, it should be used throughout the pregnancy.
Some doctors are cautious about using cotrimoxazole during the first trimester in pregnancy.
If the mother’s CD4 count is less than 350 then this is needed this for her own health, and the benefits are likely to outweigh any theoretical risks.
This is also supported by this 2014 review:
https://pmc.ncbi.nlm.nih.gov/articles/PMC4331013
This answer was updated in 2015 from a question first asked in 2006.
Hello Essie and many thanks for getting in touch.
Congratulations on your pregnancy.
I understand your concern (especially if you have done a google search) but septrin is widely used in pregnancy for women living with HIV.
I would recommend discussing it with your doctor though, because there are other medication you should also be getting at the beginning of the pregnancy that will help your baby, such as folic acid.
You have been given septrin because your immune system is not strong enough.
The medication they are giving you (ARVs) are very good and will work in building your immune system again.
The sooner this happens, the faster you will be able to stop septrin.
Hello, this is essie i have been taking septrin for the last one month yet am pregnant and in my first tremester. Could it affect my baby? Am hiv positive
Hi MC, I updated the original question to cover anyone with a CD4 count less than 350. If this is recommended for the women’s health then it is also okay during pregnancy.
What does the new guidelines say about someone who’s pregnant and on HIV medication with CD4 count above 200+ cells taking septrin in the trimester?
Hi Ife, Septrim does not effect fertility. You can still get pregnant while taking it. Septrim is used to prevent other infections while you have a low CD4 count. Have you had a recent test for yours? What were you finding difficult about taking Septrim?
HIV positive,been on ARV and Septrim but noticed dat I couldn’t take in, so I stopped the Septrim so as to take in, have I made a good decision?
Does Septrim makes one not to be pregnant?