Q and A

Question

Why am I on ilvitrim? (co-trimoxazole)

I am worried why my CD4 count is dropping so fast,what can i do to keep it above 500? I am currently put on ilvitrim, why ilvitrim?

Answer

Hello,

Thank you for your email. Can you give me a bit more information?

It would be useful if you could tell me what your most recent CD4 count is, and the last few results so that I can understand how quickly this is decreasing.

If your CD4 count is above 500, then your immune system is still very strong. This is likely to slowly go down over time until you start ARVs. This is the only proven way to increase your CD4 count.

The CD4 count guideline for starting treatment will depend on where you live. Can you tell me which country you live in? For example, in the UK, the current recommendation is to start when the CD4 count is about 350.

Ilvitrim is a brand name for two antibiotics in one pill. The generic name for this is co-trimoxazole. Other common brand names are Purbac, Septrin and Bactrim.

The two drugs in co-trimoxazole are trimethoprim (TMP) and sulphamethoxazole (SMX). It is mainly used to either prevent or treat infections, including PCP which is a type of pneumonia and toxoplasmosis which can affect your brian.

In the UK, this med is given to everybody who has a CD4 count under 200. In some other countries, especially in Africa, this is used at higher CD4 counts (under 350) because it also protects against a broad range of other infections.

As with any medicine, it is important to ask your doctor or nurse these questions so you understand this part of your life.

92 comments

  1. Roy Trevelion

    It’s important that you go to see your doctor quickly if you have any kind of skin rash when taking Ilvitrim. This includes having a mild rash.

    Ilvitrim is a brand name for two antibiotics in one pill. The generic name for this is co-trimoxazole. Other common brand names are Purbac, Septrin and Bactrim.

    It is mainly used to either prevent or treat infections, including PCP (which is a type of pneumonia) and toxoplasmosis (which can affect your brain).

    It’s important that you see your doctor very quickly in case you’re reacting to Ilvitrim.

  2. dk

    I’m taking Tribuss with Illvitrim and my whole body is itching. If I don’t take Illvitrim for one day the itching stops what must I do.

  3. Simon Collins

    Hi Dkay

    Please talk to your doctor today or as soon as possible about all these symptoms.

    Please include as much detail as possible, including the dark mood changes and you thoughts of suicide.

    Tribuss includes a drug called efavirenz, where these symptoms affect some people.

    If you still have these symptoms after three months then your doctor should change you to an alternative treatment.

    You should notice a difference immedaitely – certainly within a week.

    You should not have to put up with these side effects jut to treat HIV.

    There are alternative drugs that do not have these problems.

    Please let me know how you get on.

  4. Dkay

    I’m three months on treatment. My cd4 count was 190 and viral load 80. I’m taking Tribuss and Purbac combination. My problem is I feel like vomiting in the mornings, has a bitter taste in my mouth regularly and my eating patterns have changed. I can hardly complete my meals. I have developed craving for certain meals which I can’t even finish.I’ve started developing suicidal thoughts. I’m wondering whether I should take my colo-prep to unblock my system which currently gives me problems. I’m so confused

  5. Robin Jakob

    Hi,

    Ilvitrim is mainly used to either prevent or treat infections, including PCP which is a type of pneumonia.

    In the UK, this med is given to everybody who has a CD4 count under 200. In some other countries, especially in Africa, this is used at higher CD4 counts (under 350) because it also protects against a broad range of other infections. You can ask your clinic about continuing to take it.

  6. NTOMBI

    I am on ARVs and ilvitrim and my CD4 was 321. I am well,can I still continue with ilvitrim?

  7. Simon Collins

    Hi

    It is not clear whether you mean either:
    i) alternative manufactured versions of cotrimoxazole
    or
    ii) alternative medicines to cotrimoxazole.

    Either way, this is something you need to ask your doctor about.

  8. ANIS XABIIB

    what could be other alternative without ilvitrim

  9. Rebecca McDowall

    hi,
    Sorry but I don’t understand your question. An FDC (fixed dose combination of HIV drugs) should help to maintain or increase your CD4 count. Ilvitrim should help prevent or treat opportunistic infections.

    If this doesn’t answer your question please can you explain further so that I can try to help.

  10. BabeBoe

    I’m taking fdc but they gave me ilvitrim, is that won’t drop my cd4 count?

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