Should contrimoxazole prophylaxis be taken by all adults with HIV in Africa?

Grimwade et al. presented convincing information regarding the effectiveness of cotrimoxazole prophylaxis in preventing mortality among patients with tuberculosis in South Africa, even without testing for HIV. Another recent trial presented data regarding the efficacy of cotrimoxazole prophylaxis among children with HIV infection in Zambia regardless of the CD4 cell count or age. As a result of that study, the World Health Organization (WHO) and the Joint UN programme on HIV/AIDS (UNAIDS) developed interim guidelines that recommend prophylaxis for all symptomatic children with HIV infection, eliminating previous criteria using CD4 cell percentages.