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 Norbert,
In response to your questions:
1. What is the difference between ATRIPLA and TLD and what are their efficacies? TLD contains the following ARVs: tenofovir disoproxil lamivudine and dolutegravir, please see here: https://i-base.info/guides/14970 Atripla contains: tenofovir disoproxil, emtricitabine and efavirenz, please see here: https://i-base.info/guides/1561 TLD is a newer combination and has less side effects, though weight gain can be an issue. The World Health Organisation now also recommend it as first line treatment in countries like South Africa. Both combinations are effective.
2. Can one switch to TLD from ATRIPLA with no worries? Many people do and are switching, before you switch you should discuss this with your doctor.
3. At what stage in viral load and CD4 Count does one stop or start on septrin? Septrin is an antibiotic, it’s taken by people who are positive when they have a CD4 count of less than 350 (this is if you live in Sub Saharan African) or 200 if you live in the UK.
I have some questions.
1. What is the difference between ATRIPLA and TLD and what are their efficacies
2. Can one switch to TLD from ATRIPLA with no worries
3. At what stage in viral load and CD4 Count does one stop or start on septrin.
Hi Eddie’s,
Septrin is an antibiotic, it’s not an ARV. If you’re wanting to take septrin again you’ll need to talk to your doctor.
I’ve stopped taking seprin for two months and my viral load is undetectable. Is it safe if I start taking them again
Here in kenya we were told that those with zero viral load should stop taking seprin and I am one of them. So is it safe because I have taken them for ten years
Hi Sally,
Septrin is an antibiotic. It’s taken by positive people when they have a CD4 count of less than 350. If your CD4 is above this, then I don’t see why you need to use it.
Hi Sally,
Do you know why you’ve needed to take septrin for 10 years? This is a long time.
Is it safe to stop taking seprin after taking it for over ten years
Hi Robert,
I’m sorry that you don’t feel well.
But can you tell us a bit more? Such as what HIV meds you’re taking. And if you have access to your CD4 count and viral load results, please tell us what they are.
Please let us know.
I don’t know what to say about this sickness. I don’t feel well