Late diagnosis of HIV infection in Brazil despite over 15 years of free and universal access to treatment

摘要

Editor: There is an abundance of data to indicate that the CD4 cell count at the time of initiation of antiretroviral therapy (ART) has major prognostic impact. Mortality is markedly higher in patients initiating ART at advanced stages of HTV disease compared to those who initiate earlier and the increased risk of death remains significant for several years.1 For individuals who reach normal levels of CD4 counts (> 500 cells/mm3) in response to ART, the risk of death might be similar to the general population.2 On the other hand, a substantial proportion of individuals who start therapy with low CD4 counts, particularly if below < 200 cells/mm3, do not reach normal levels, despite several years of successful therapy.3 Recently, the impact of ART on reducing HIV transmission has been convincingly demonstrated.