HIV with high CD4 count: early ART reduces risk for severe bacterial infections

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Takeaway

  • Immediate antiretroviral therapy (ART) reduces risk for a broad spectrum of severe bacterial infections in HIV-infected patients, and appears to be mediated partly by increases in CD4 cell count, but not neutrophils.

Why this matters

  • Effect of early ART on bacterial infections is important because these events are common in HIV-infected patients.

Key results

  • After median follow-up of 2.8 y, 120 of 4685 HIV-positive patients had severe bacterial infections (immediate-initiation group n=34, deferred-initiation group n=86).
  • Immediate vs deferred ART was associated with reduced risk for severe bacterial infection (HR, 0.39; P<.0001).
  • Average neutrophil and CD4 cell counts were 321.4 cells per μL and 194.2 cells per μL higher, respectively, in immediate- vs deferred-initiation groups (P<.0001).
  • On univariable analysis, higher time-u...