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.
Hey have been diagnosed with HIV+ and my cd4 is 375 and i was advised to start taking septrin is it possible to take septrin for a long time without starting ARVs? And is waking up every morning with one sided headache a results of the medicine?
thanks again for your worth advices
Hello Avinash,
I’m sorry to hear about your recent diagnosis. It’s good that you’ve started treatment though- how are you getting on with this?
In the UK you would have your CD4 count checked 1 month, 3 months and then every 3–4 months after starting treatment. You would also have your viral load checked at these times as a measure of how well treatment is working. This can be different depending on which country you live in.
Life expectancy is very good with HIV treatment. With good adherence (taking your meds properly every day) life expectancy is very good, and close to that of HIV negative people.
Hi My name is Avinash I have recently been diagnosed with HIV and my CD4 count is 184 and I am under ARV treatment its been almost a week I have started my treatment How soon can I check my cd 4 count whether it has increased or not and what are my chances to survive if i take the medicine on time thoroughly as I am 40 years of age will I be able to live for more 10 to 15 years if I take medicines on time without any miss
Hi Nathaniel,
It is very likely that you will need treatment at some point. Most guidelines recommend starting ARVs when your CD4 count is under 350. The best way to keep your CD4 count high is to eat a healthy diet and look after yourself. But the only way to increase your CD4 count is to take ARVs.
I have been HIV positive for 6 years now and am still on septrin,my cd4 is 400.i weigh 65kgs.i want to add weight what can i do.And what should i do not to start arv treatment?
Hi Derek, please see this page about malaria.
I have HIV and am in atripla.i aways get malaria and am treated but every after two weeks am down with it.can i start septrin even when my cd4 is 800.or what can i do to stop the malaria.
Hello Stefania,
This is a very good CD4 count. Above 500 is considered to be ‘normal’ (for people without HIV). Depending on where you live you will be recommended to start treatment when your CD4 count is either under 500, or under 350. For now the best thing you can do is to look after yourself (eat well, exercise, give up smoking) and go for regular check ups with your doctor. It’s a good idea to learn about HIV treatment so that you are ready to start when you need to. Our Introduction to combination therapy guide has information about what to expect.
You may also like to join a support group or online forum such as poz.com or myHIV to meet other positive people.
I wish you the best of luck- please let me know if you have any questions!
I am HIV positive. My CD4 count is 505. What do I have to do? I am not taking anything. Thanks
Hi. As you have just been diagnosed it must still be a difficult time. As your CD4 count is so high, this means you are likely to have plenty of time to find out about HIV and treatment. Over time, without treatment, nearly everyone will see their CD4 count trend decrease. Usually this takes place over many years. This is not a reason to add to your worries now though. There is no convincing evidence that starting treatment at such high levels will after your health, compared to waiting until it reaches 500, or arguably 350. This will be something to discuss with your doctor though. Septrin is sometimes given at high CD4 counts depending on where you live, so this is again something to ask your doctor about.