Q and A


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?



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.


  1. Roy Trevelion

    Hi Eunice,

    Babies are not really ready to have food at 10 weeks. So please talk to the doctor or nurse about feeding him.

    It’s good that he’s had nevirapine and ilvitrim. But it’s a good idea to talk to the clinic about the best way to feed your baby to make sure he stays healthy.

    Here’s the guide to HIV pregnancy and women’s health.

  2. Eunice

    Hi my son is 10 weeks i give him food is it dangerous?he was on nevaripin for 6 weeks and they gave me ilivitrim suspension.Its good for my son’s health to give him food? Please advise.

  3. Lisa Thorley

    Hi Amanda,

    If you son hasn’t already had his first HIV test, please discuss this with his doctor.
    Ilvitrum is an antibiotic, it isn’t an ARV. In some countries, babies born to positive mothers are given it. Again, this is something that you’ll need to discuss with your sons doctor.

  4. Amanda

    Good afternoon my son is 1 month 11 days they gave him nevarapine after 7 days then today they gave him ilvitrim but I’m not breastfeeding and I don’t know the status of my son

  5. Lisa Thorley

    Hi Zenny,

    In some countries babies are given ilvitrim when they are 6 weeks old. This isn’t an ARV, its an antibiotic. Yes its safe to give to babies.

  6. Zenny

    Good day, I’m HIV + my baby tested for HIV but I haven’t received the results yet, I went to 6 weeks visit and I was told to stop nevirapine and start ilivitrim, is it safe thou for my baby? Remember I don’t know his status yet. I myself on treatment.
    Thank you

  7. Lisa Thorley

    Hi Nelly,

    If you were in the UK, your baby would be on ARVs for the whole time that you breastfeed. However, the guidelines around infant feeding change depending on where someone lives, as well as to what medication they should be given. This is something that you will need to discuss with your childs doctor.

  8. Nelly

    Hi my baby was born hiv negative so thy gaver her nevripane since she was born bt nw i went fir 6 weeks nd thy gave her llvitrim to take until 10 weeks nd am breastfeeding her will thy medicine help her nt to b infected coz i take my arv correct nd correct time so i want to khw will it b a bad idea if i change her to formula at 10 weeks ?

  9. Roy Trevelion

    Hi Maria,

    It’s good to hear your baby was born HIV negative. But it’s important to talk to the doctor about his treatment.

    Ilvitrim is an antibiotic. It’s used to treat or protect against other infections but not HIV. You can ask the doctor how long your son needs to take ilvitrim.

  10. Maria

    I’m HIV+ my son born negative,i breastfeeding him until three months,now have 4month and 2weeks I just want to know when can I stop giving ilvitrim suspension bcz I stop breast-feeding him


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