Question
Do I need to continue taking cotrimoxazole prophylaxis?
21 June 2023. Related: All topics, Opportunistic infections, Starting treatment.
hi i am hiv+ since 12 years … I’m Using ARV medication since 9 month … my viral load is undetectable level and cd4 is 175 and I’m taking Tavin-M (tenofovir+FTC) and Atazor-R (atazanavir).
My dr is also giving me Becosules Z and Sepmax (cotimoxazole) daily one tablet and Zocon 150 (acyclovir) one tablet in a weak … want to know why he is giving me extra tablets ?.. I don’t like Sepmax can I discontinue this tablet?
Answer
It looks like you are having a great response to treatment.
Has your doctor explained why you are being prescribed these other meds and how long you need to take them for?
Sepmax is a generic form of an antibiotic. It is also called cotrimoxazole and is a combination of sulfamethoxazole and trimethoprim (other names are Septrin and Bactrim).
This is recommended for anyone whose CD4 count is under 200. It protects against a chest infection called PCP and other infections. If you have never had these problems your doctor might say it is okayyou stopping this now, or may want you to continue a bit longer.
In the UK, once a person’s CD4 count increases to above 100 cells when on treatment, then they can stop Septrin. That is only if they have never had PCP.
Anyone 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).
Some countries recommend continuing above 200, so it depends on the country you are living in.
Becosules is a multivitamin – again, ask your doctor how important this is. If you have a balanced diet and you don;t have a vitamin deficiency, your doctor may decide this is optional or may still recommend this.
Finally, Zocon is an antifungal drug and whether you continue this will depend on your previous health and history.
All these meds are commonly used by HIV positive people. Your questions are all good though and your doctor should take time to explain this to you, together with how long you are likely to need to continue taking them.
Updated in June 2023 fro a question first posted in November 2011.
Hi Sashi, do you know what your CD4 count and viral load is?
Co-trimozaole is used to prevent PCP (after you were initially treated). Usually this is only needed as your CD4 count recovers.
Are you on HIV treatment? In most countries it is recommended that co-trimoxazole to prevent PCP is no longer needed once your CD4 count is greater than 350.
Hi,
I’m Sashi Karaingathil ,I dignoseed PCP (viral pneumonia) on 2021 October
My doctor prescribed me co-trimoxazole 80/400mg weekly 2 tablets weekly three times life long. Because my low immunity .