Q and A

Question

Should I continue taking septrin if my CD4 count has risen to above 200?

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. 

113 comments

  1. Lisa Thorley

    Hi Faith,

    If the nurse isn’t being helpful you should take your son to see a doctor, and not a nurse. They should be able to advise.

  2. faith

    my son is six months and is on kaletral solution and abacavir the problem is when am i give him the drugs he fails to breath i tired tellin the nurse she said he will get used but his becoming worse what should i do

  3. Lisa Thorley

    Hi PERUTH,

    What’s your CD4 count? If its less than 200 then this may be why you’ve been told to continue to take it. Is this something that your doctor has talked to you about?

  4. PERUTH

    Hi, I have been on arvs for four years and my viral load is excellent but I still take septrin too as prescribed by my treatment center. Is it still necessary to continue having septrin with my daily atripla tablet? Am in Uganda

  5. Lisa Thorley

    Hi Ssali,

    ARVs and septrin are used for different reasons. ARVs are used to control HIV, whereas septrin is an antibiotic that is used to treat, and or prevent infections. Its commonly used when someone has a CD4 count of less than 200, and in some countries when a person has a CD4 count of less than 350. Its fine to take them together.

  6. Ssali

    Does it affect me if i take arvs without taking septrin?

  7. Lisa Thorley

    Hi Emmanuel,

    You should be OK. But you should try and take it as prescribed.

  8. Emmanuel

    what happen when u miss your septrin for a day and will any side effect

  9. Lisa Thorley

    Hi Nanny,

    You’ll be fine, it won’t cause you any problems.

  10. Nanny

    I take my ARV at nine pm and a septrin at 7am. Today I confused n took a seprin instead. Can it harm me for taking septrin twice?

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