The mortality of HIV persists in highly active therapy

Despite highly active antiretroviral therapy (HAART), HIV-positive HIV + patients have a mortality rate significantly higher than the general population, depending on the number of CD4 recorded at the beginning of treatment, indicate the results of a Danish study.
The prognosis of HIV infection has improved considerably with the use of HAART, but no study was interested in the comparison of mortality between HIV + patients on HAART and the general population.

Soren Jensen-Fangel Hospital of Aarhus and colleagues compared the mortality rate of a group of 647 HIV + patients on HAART with that of 64,700 people in the general population.

During the three and a half years of follow-up, the authors reported 53 deaths in the group of HIV + and 815 in the control group.

An increased risk of death was observed in all groups considered positive, compared with the general population. In addition, this risk shows higher as the concentration of CD4 was low at the start of treatment.

Thus, compared to the general population, the risk of death is multiplied by 15 in HIV + with a CD4 count below 50 million cells per liter at the start of treatment by 8.6 CD4 including between 50 and 99 million cells per liter, 5.9 between 100 and 199 million cells and 3.6 for a number of more than 200 million cells per liter CD4.

For patients initiating HAART with a number greater than 200 million cells per liter CD4 mortality therefore shows similar to that observed in other chronic diseases, such as insulin-dependent diabetes young.

Given this significant increase in the mortality rate for a treatment initiated while the impairment of the immune system is already proving severe (with a low CD4 count), the authors suggest starting HAART early enough.