Delaying uptake of antiretroviral treatment (ART) may have serious consequences for older people living with HIV. According to research published in Clinical Infectious Diseases, patients aged between 45 and 65 who started ART at CD4 counts below 350 had higher mortality rates compared to people who started treatment when their counts were around 500.
“Delaying ART had profoundly deleterious effects,” said investigators. “Delaying ART until CD4 count dropped below 200 increased ten-year mortality from 19 percent to 28 percent.” US researchers from the CFAR Network of Integrated Clinical Systems (CNICS) monitored ten-year mortality rates according to age and CD4 counts at the time of ART initiation in 3,532 PLHIV. The study found a clear relationship between CD4 counts at ART initiation and mortality rates.
“The striking increase in ten-year mortality under delayed ART initiation for adults over 45 years stresses the heightened importance of early ART initiation in this group,” conclude the investigators. The findings follow the START study results that showed that commencing treatment as close to diagnoses as possible irrespective of CD4 count reduced the risk of illness or death by 50 percent