The government has defended its decision to prescribe antibiotics for all HIV-positive patients regardless of the strength of their immunity.
Dr Ibrahim Mohamed, the director of the National Aids and STD Control Programme, said public health institutions would continue to follow government guidelines on the treatment of those infected with HIV.
“We cannot wait until a person’s CD4 count is below 350 to start giving Septrin,” said Dr Mohamed.
He was responding to a report in the Nation on Friday in which doctors expressed concern about the use of cotrimoxazole for prophylaxis or preventive purposes in public hospitals.
The doctors said the drugs were only useful to patients whose CD4 count was below 350 because the bodies of those whose count was above 410 were still capable of fighting opportunistic infections. The CD4 count measures the strength of a person’s immune system.
Cotrimoxazole, sold in the market as Septrin and Cosatrim, is used to protect people with HIV from bacterial and malaria related opportunistic infections.
Some doctors expressed fears that indiscriminate and prolonged use of the drug by HIV-positive patients might result in the emergence of resistant strains of bacteria.
But the government insists that the issue of resistance does not arise because the drug is not used for treatment but for preventive purposes.
Dr Mohamed said the government’s decision was based on studies that showed the benefits of cotrimoxazole in sub-Saharan Africa.
“In poor countries, where people have not been vaccinated against some opportunistic infections, there are no clear guidelines at what level of CD4 count should be used to put people on Septrin prophylaxis,” says Dr Mohamed.
Developed countries can use the 200 CD4 count threshold because the patients are vaccinated against pneumonia and diarrhoea, the most common opportunistic diseases, he added.