Excess Mortality in Untreated HIV-Infected Patients with High CD4-Cell Counts

HIV-infected patients with low CD4-cell counts have high mortality rates, but evidence is accumulating that untreated patients with higher CD4-cell counts might also be at excess risk for clinical complications. Investigators recently conducted a multinational cohort study to determine whether such individuals have an elevated death rate.

The study involved 40,830 patients aged 20 to 59 from North America and Europe who had at least one CD4 count >350 cells/mm³ and who had not started antiretroviral therapy (ART). Standardized mortality rates (SMRs) were calculated by comparing death rates observed in HIV-infected patients with those expected in the general population.

During 80,682 person-years of follow-up, only 1% of patients died; most of…