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Antiretroviral (ARV) therapy significantly decreases the risk of non-AIDS-related illnesses in people with CD4 counts below 350, according to a study published in the October 15 issue of Clinical Infectious Diseases and reported by aidsmap.com.
The SMART study, which compared treatment interruptions with continuous ARV treatment, found that being off treatment with a CD4 count below 350 was associated with a higher rate of non-AIDS illnesses, including cardiovascular, kidney, lung and liver diseases and cancers. This finding led experts in Europe and the United States to recommend starting ARV treatment as soon as a person’s CD4 count dips below 350.
To confirm the results of the SMART study, Richard Moore, MD, and his colleagues from Johns Hopkins University in Baltimore, analyzed the medical records of 2,824 HIV-positive patients within the Johns Hopkins medical system who were seen between 1997 and 2005. The average age of the patients at the time they were enrolled into the study was 38, two thirds were men and 75 percent were black.
Moore’s team found that not being on antiretroviral therapy was significantly associated with experiencing a non-AIDS-related illness in all people with CD4 counts below 350. In people with CD4s below 200, people not taking ARV therapy were almost twice as likely as people on ARV treatment to experience a non-AIDS-related illness. In people with CD4s below 350, those not taking ARV treatment were 30 percent more likely to experience a non-AIDS-related illness.
The trend extended toward an increased likelihood of a non-AIDS-related illness in people with CD4s above 350 who were not on ARV treatment, but this did not reach statistical significance. In other words, the difference may have occurred by chance.
