A senior Ministry of Health official yesterday said a select committee, which reviews the ministry’s care and treatment programmes, recommended that administration of Cotrimoxazole, commonly known as Septrin, to persons living with HIV/Aids with suppressed viral load is unnecessary.

The head of the HIV/Aids programme, Dr Joshua Musinguzi, explained that continued administration of Cotrimoxazole to such persons might lead to a negative impact on antiretroviral drugs (ARVs) adherence.

He said the findings were used to inform their policy shift in August that initially emphasised that every person living with HIV must swallow Cotrimoxazole and has now restricted it to only those newly enrolling on ARVs, expectant mothers and children below the age of 15.

“Initially, we were stuck. We were giving people counselling. We did not have ARVs. Patients were coming in with opportunistic infections. But there was also evidence that Cotrimoxazole can prevent many of these opportunistic infections such as pneumonia, other bacterial infections and some effect on malaria prevention. It was a big piece of news that you can use Septrin to reduce these infections,” Dr Musinguzi said on Tuesday at a media briefing. He added: “We started universal access of Cotrimoxazole to all HIV positive patients in addition to counselling. When we brought ARVs, we continued with that policy and it worked well. And people got used in using these drugs alongside each other.”

However, Dr Musinguzi said they later tasked their scientists to find out whether there was any impact of Cotrimoxazole on patients already enrolled on ARVs.

“That data indicated that Septrin is good but not necessarily good for every individual. There was a feeling that additional pill burden of Cotrimoxazole for individuals who don’t need them at all may bring a negative impact on adherence for ARVs. That is the evidence we used to review our guidelines and to make our new policy,” he added.

Dr Musinguzi explained that Cotrimoxazole is not an ARV but an anti-bacterial drug, which they has been used by people living with HIV to prevent the development of opportunistic infections.

“We can actually use the savings from that wastage we were making and rationalise the money and use it to buy other commodity supplies,” he said.