Late Diagnosis and Delayed Entry into Care Continue to Limit the Benefits of ART

Evidence continues to accumulate that starting antiretroviral therapy (ART) at higher CD4-cell counts — and then maintaining higher counts — leads to better clinical outcomes. Several studies presented at CROI 2012 reinforced this.

Using data from the SMART and ESPRIT studies, as well as the Human Mortality Database, Alison Rodger and colleagues compared mortality rates between the general population and HIV-infected patients who were on ART, did not use injection drugs, and had both suppressed viral loads and CD4 counts ≥350 cells/mm³ [Abstract 638]. Despite virologic suppression, HIV-infected patients with CD4 counts between 350 and 499 cells/mm³ had significantly higher mortality rates than the general population. No significant differenc…