Question
Should I continue taking septrin if my CD4 count has risen to above 200?
24 January 2023. Related: All topics, Opportunistic infections.
How long can a person take Septrin?
Is it ok to continue taking it even if CD4 levels have risen (from below 10 to 270)?
Thanks.
Answer
It is really good news that your CD4 count has risen to 270 cells from such a low count.
Septrin is prescribed as prophylaxis against PCP [a type of pneumonia] when someone has a CD4 count of below 200 cells, and against toxoplasmosis (a type of brain infection) someone is at risk of developing with a CD4 count of less than 100 cells.
In the UK, once a person’s CD4 count increases to above 100 cells when on treatment, then they can stop Septrin. That is, unless they have previously had PCP.
For someone who has previously had PCP, it is recommended to continue until the CD4 count is above 200 cells/mm3. This is based on EACS guidelines (v11.1, October 2022).
In some African countries, Septrin is recommended until the CD4 count is over 350 (and sometimes until over 500). This is because the background risk of infections can vary in different countries.
In countries with high risk of malaria or severe bacterial infections, prophylaxis should continue, irrespective of CD4 count on ART. There are also different recommendations for children and in other specific circumstances. (WHO consolidated guidelines, 2021)
In terms of safety, if your doctor has recommended that you continue taking the septrin, then this is very safe to do so.
This pot was updated in January 2023 from a question frost answered in January 2012.
Hi Josh and ur team have a blessed festive season and continue with relevant information for people who need it God bless
Hi Florence, what is your CD4 count? and do you know your viral load? When you have stopped Septrin in the past what sort of illnesses have you had?
I have been living with HIV for the last 30 years. However high my CD4 count is if I stop taking cotrim (septrin) I start falling sick of various illnesses and become weak. Much as I feel I should follow what health workers are advising me to stop taking septrin when my CD4 is good, again am scared of how weak am likely to become. What should I do. Help.