More Dangerous Than Opportunistic Infections?

Perhaps instead of warning HIVers that they are at risk for AIDS-related opportunistic infections if their CD4-cell counts are low and their viral loads are high, it may be more accurate to simply say they're at risk for dangerous infections of all sorts, say researchers in a study in the Journal of Acquired Immune Deficiency Syndromes. And, surprisingly, the risks for some ailments -- like liver disease, heart disease, and non-AIDS-defining cancers -- actually begin to rise long before OI risks are present, they report. A CD4-cell count below 200 dramatically raises risks for AIDS-related opportunistic infections, according to international guidelines. But a CD4-cell count above 200 was linked with severe non-AIDS-defining illnesses, according to an analysis of nearly 1,300 French HIV patients. With regard to non-AIDS-related cancers, risks increased when CD4-cell counts dropped below the relatively high 500-cell threshold. The two-year analysis also showed that serious non-AIDS-related diseases -- and deaths caused by them -- were much more common than AIDS-related ailments and deaths. In light of their findings, the researchers say successful antiretroviral therapy is vital in preventing the onset of not only AIDS and HIV-related OIs but other serious diseases. "Optimization and permanent continuation of long-term antiretroviral therapy in HIV-infected patients is the best strategy to prevent or reduce the occurrence of non-AIDS severe morbidity," they write.