OBJECTIVE: There is limited research investigating the possible mechanisms of how starting combination antiretroviral therapy (cART) at a higher @entity404 cell count decreases mortality. This study investigated the association between initiating cART with short-term and long-term achievement of viral suppression; emergence of any drug resistance and of an @entity791 ( @entity791 ); long-term treatment adherence; and all-cause mortality. METHODS: This retrospective cohort study included 4120 naive @entity1 who initiated cART between 2000 and 2012. @entity1 were followed until 2013, @entity204 or until the last contact date (varied by outcome). The main exposure was the interaction between period of cART initiation (2000-2006 and 2007-2012) and @entity404 cell count at cART initiation (<500 versus >= 500cells/ l). We considered both baseline and longitudinal covariates. We fitted different multivariable models using cross-sectional and longitudinal statistical methods, depending on the outcome. RESULTS: @entity1 who initiated cART with a @entity404 cell count at least 500cells/ l in 2007-2012 had an increased likelihood of achieving viral suppression at 9 months and of maintaining an adherence level of at least 95% over time, and the lowest probability of developing any resistance and an @entity791 during follow-up. These @entity1 were not the ones with the highest likelihood of maintaining viral suppression over time, most likely due to viral load blips experienced during the follow-up. CONCLUSION: The outcomes in this study likely play an important role in explaining the positive impact of early cART initiation on mortality. These results should alleviate some of the concerns clinicians may have when initiating cART in @entity1 with high @entity404 s as recommended by current treatment guidelines.

Initiation of antiretroviral therapy at high XXXX + cell counts is associated with positive treatment outcomes.

@entity1 :: ('9606', 'Species') :: ['Patients', 'patients'] @entity791 :: ('MESH:D000163', 'Disease') :: ['ADI', 'AIDS-defining illness'] @entity404 :: ('920', 'Gene') :: ['CD4'] @entity204 :: ('MESH:D003643', 'Disease') :: ['death']
@entity404 :: (920,Gene) :: ['CD4']
