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HIV Tied to Higher Death Risk Even With High CD4 Counts

Last Updated: July 16, 2010.

HIV infection appears to increase the risk of death in antiretroviral therapy-naive patients with CD4 counts greater than 350 cells per µL compared to the general population, although the increased risk appears relatively modest, according to a study published online July 16 in The Lancet.

FRIDAY, July 16 (HealthDay News) -- HIV infection appears to increase the risk of death in antiretroviral therapy (ART)-naive patients with CD4 counts greater than 350 cells per µL compared to the general population, although the increased risk appears relatively modest, according to a study published online July 16 in The Lancet.

In a pooled cohort observational study, Rebecca K. Lodwick, of the University College London Medical School, and colleagues merged data from 40,830 patients, aged 20 to 59 years, who had at least one CD4 count greater than 350 cells per µL while ART-naive. The patients were from 23 European and North American cohorts. The researchers assessed mortality for four risk groups: men who have sex with men, heterosexual individuals, individuals using injectable drugs, and those at other or unknown risk.

Of 419 deaths, the researchers included 401 deaths in standardized mortality ratio (SMR) analysis. They found that 100 men who have sex with men had a 30 percent increased risk of mortality compared to the general population. In addition, 203 injecting drug users had an SMR of 9.37, 68 heterosexual individuals had an SMR of 2.94, and 30 in the other or unknown risk group had an SMR of 4.57. The death rate was lower in patients with CD4 counts of 500 to 699 cells per μL (adjusted rate ratio [aRR], 0.77) and counts of 700 cells per μL (aRR, 0.66), compared to those with CD4 counts of 350 to 499 cells per µL.

"These data suggest that people with HIV who have not taken ART and have CD4 count greater than 350 cells per µL have a raised risk of death compared with the general uninfected population, although the increase seems to be small," the authors conclude.

Most members of the analysis and writing committee disclosed receiving funding from pharmaceutical companies in the past.

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