Co-trimoxazole is a broad-spectrum antimicrobial medicine that prevents a range of secondary bacterial and parasitic infections in eligible people living with HIV. Daily prophylaxis with CPT prolongs survival and reduces the incidence of comorbidities in children living with HIV. It also reduces the risk of coinfections such as pneumocystis pneumonia in infants exposed to HIV. CPT is recommended for all HIV-exposed infants and children living with HIV, including those with TB (79), and should be implemented as an integral component of a package of HIV-related services (see Box 7.2).
Indications for initiating, discontinuing and monitoring CPT are included in the 2021 WHO consolidated guidelines on HIV prevention, testing, treatment, service delivery and monitoring (78).