Prolonged Co-trimoxazole Is Beneficial for Children on ART in Sub-Saharan Africa

Co-trimoxazole is widely used in sub-Saharan Africa before antiretroviral therapy (ART) initiation because it reduces mortality, morbidity, and hospitalization rates in HIV-infected individuals. Current guidelines, which are based largely on observational data from Europe and the U.S., state that co-trimoxazole may be discontinued in children aged >5 years if they have good adherence to ART for more than 6 months, a full clinical recovery, and a CD4 count >350 cells/mm³.

In a recent open-label, controlled trial, researchers examined the effect of stopping co-trimoxazole in pediatric patients in Africa, where bacterial infections and malaria are common. A total of 758 children and adolescents in Uganda and Zimbabwe who had received ART for >9…