Question
Can co-trimoxazole reduce my CD4 count?
6 July 2023. Related: All topics, CD4 and viral load, Side effects.
Hi,
I recently had my blood work done again. My CD4 is now 228. Last time it was 204.
I have been taking co-trimoxazole as my CD4 was 64 when diagnosed.
My doctor phoned me today and said she has looked at my latest blood results and has noticed a downward trend in my white blood cell count (neutrophils).
She has told me to stop co-trimoxazole as it could be the cause, as it was fine before I started any of my medication. If it doesn’t work, then she may have to change my HIV medication.
I’m freaking out a bit now as I’ve done the worst thing, and done some research on Google. Leukaemia is something that keeps popping up.
Has anyone had this type of problem before?
Thank You
Answer
Hi, how are you doing?
It is good that your doctor is being proactive and looking fo reasons why your CD4 count is on a downward trend.
Have you been told your CD4% also? This is often more accurate than an absolute CD4 count. The absolute count can be different each time due to other factors e.g., exercising or the time of day the blood was drawn. As you don’t have significant changes in your absolute count this is a possible reason for the apparent decline.
Stopping co-trimoxazole is a good idea. This antibiotic contains trimethoprim. A side effect of this drug being that it can suppress bone and stop new blood cells being made. Stopping the treatment will mean the bone will no longer be suppressed.
While leukaemia is a possible reason for this drop, it is very unlikely in your current situation. There are a number of more common causes for this drop. Have you mentioned this concern to your doctor? They would be have a conversation with you and more appropriately explain why leukaemia is unlikely.
Josh.
HiDave, oh that’s good. Sorry for the confusion. White blood cells is just an umbrella term for all of the white cells. It is good that your doctor has identified that it is neutrophils.
Oh, okay. My doctor said the only white blood cells that have shown a downward trend are the neutrophils. Everything else is fine, apparently.
Cheers
Hi Dave, CD4 count is part of your white blood cell count. CD4 cells are called lymphocytes and these make up some of the cells that fall under the white blood cell category.
Hi,
My CD4 count isn’t on a downward trend. It’s my white blood cell count. My CD4 count is fine.
I’ve stopped taking co-trimoxazole now, and I’ve got to have blood taken again in 1 month to see if my WBCals have increased.
Thanks