People diagnosed with HIV when they have a high CD4 count who start treatment promptly reduce their one-year risk of death by about two thirds, aidsmap reports.
Publishing their findings in Clinical Infectious Diseases, researchers in China conducted a retrospective study of 35,500 adults diagnosed with HIV between 2012 and 2014. The cohort members had a CD4 count above 500 and were followed for 12 months following their diagnosis.
The researchers compared the death rate during this time between three categories of people: those who started antiretroviral (ARV) treatment within 30 days of their HIV diagnosis (immediate treatment, 5 percent of the cohort); those who started treatment between 31 days and a year following their diagnosis (deferred treatment, 16 percent of the cohort); and those who were not treated during their first year post-diagnosis (no treatment, the remainder of the cohort).
The cohort members had a median age of 32. Three quarters of them were male. Upon diagnosis, they had a median CD4 count of 616.
A total of 790 members (2 percent) of the cohort died during the follow-up period, for an overall death rate of 2.31 percent per year. A respective 19, 58 and 713 of those in the immediate, deferred and no treatment groups died, for respective death rates of 1.04 percent, 2.25 percent and 2.39 percent per year.
Three quarters of the deaths were due to non-AIDS-related causes, most commonly cardiovascular disease.
After adjusting the data for various factors, the researchers found that compared with those in the no treatment group, those in the immediate treatment group had a 63 percent lower risk of death within the first year following diagnosis, and those in the deferred treatment group had a 26 percent reduced risk.
Other factors associated with an increased risk of death during the one-year follow-up period included: being older than 50, compared with being younger (2-fold increased risk); being male, compared with being female (1.9-fold increased risk); having only a primary education or less, compared with having more education (1.9-fold increased risk); and contracting HIV through heterosexual sex (4.2-fold) or injection drug use (5.1-fold increased risk), compared with contracting the virus through other means.
To read the aidsmap article, click here.
To read the study abstract, click here.