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Under optimal conditions,
HIV-infected people on effective antiretroviral therapy (ART) who have
undetectable viral loads and “near-normal” levels of immune cells have a risk
of death that is similar to uninfected people, according to Dr. Alison Rodgers
of University College London.
These results are based on a
three-year study of 3,300 “optimally treated” HIV-infected patients from two
large treatment studies, the ESPRIT and SMART trials. Study participants were
non-injection drug users whose ART had resulted in undetectable HIV levels and
relatively high CD4+ counts (at least 350 cells/mm3). The average age of study
participants was 43, and 80 percent were male. During the study, 62 HIV
patients died, mostly from cardiovascular disease or “sudden” death (31
percent) and cancers unrelated to HIV (19 percent). Only two died from AIDS-related
causes.
The risk of death was 77 percent
higher than the general population for patients whose CD4+ cell count was lower
than normal (350 to 499 cells/mm3). The risk of death for HIV patients with
CD4+ cell count of 500 cells/mm3 or higher was about the same as the general
population’s risk of death.
Rodgers and his colleagues urged
people to be tested for HIV since early diagnosis and optimal treatment can
prevent mortality associated with HIV. The researchers also recommended
additional research to identify the level of CD4+ cell counts that warrant ART.
The full report, “Mortality in Well
Controlled HIV in the Continuous Antiretroviral Therapy Arms of the SMART and
ESPRIT Trials Compared to the General Population,” was published online in the
journal AIDS (2013; doi: 10.1097/QAD.0b013e32835cae9c).
The Friends of AIDS Foundation is
dedicated to enhancing the quality of life for HIV positive individuals and
empowering people to make healthy choices to prevent the spread of the HIV
virus. To learn more about The Friends of AIDS Foundation, please visit: http://www.friendsofaids.org.
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