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.
Hi Joan, what is your reasoning for not taking Septrin yet? If your CD4 count is below 200 it is important to start as early as you can. Septrin will help with your own health. Healthy mum helps with healthy baby.
Am pregnant also
Have just been diagnosed with HIV and given TLD and septrin
But for the sake of mum an not going to take septrin since it’s still six weeks
Let me hope I can take septrin when six months pregnant with no side effects
Hi Rachael,
Are you taking ARVs? I’m asking as septrin isn’t an ARV, it’s an antibiotic. Yes you can use septrin when pregnant.
Am hiv positive and pregnant and am in 2 trimester I take septrin can the baby be affected
Hi Mercy,
If you’re asking if it’s safe to take septrin when you’re positive, the answer is yes. With regards to pregnancy, as the above post explains, some doctors will be cautious in the first trimester. How many weeks pregnant are you?
You’ve said that your CD4 is 1300, can you please just confirm that this is correct. If your CD4 is 1300, then I’m not sure why you’ve been prescribed septrin. Septrin will be given to someone if they have a low CD4 count, which if yours is 1300, then it’s not low.
How long have you been taking ARVs? If it’s more than 3 months then your viral load should be undetectable.
Am pregnant and am Hiv and have been given septrin and I take arvs my CD4 count is 1300 is it safe? My viral load is detectable, what can I do?
Hi Zami,
When have you been given cotrimoxazole? Is your CD4 less than 200? If it isn’t then I don’t know why you’ve been given it.
Im HIV positive and pregnant. I started ARVs in 2010, mu viral load was usually showing coming out undetected before I got pregnant but ever since I started antenal during my first trimester I was given cotrimoxazole to take every morning together with ARVs. Now questions is, is it safe for baby? Because am told to take upto the time I’l deliver
Hi Ambrose,
It is important that all pregnant women take ARVs to prevent passing HIV to their child. You can read about treatment for pregnancy women in our pregnancy guide.
Are you HIV positive and pregnant? If you are what is your CD4 count and have you started treatment yet?
if the CD4 cel acount of apregnant mother is obove 200 then what can you give.thanks