AIDS-Defining Opportunistic Illnesses in the U.S.

HIV/AIDS Clinical Care [free full text]: "Comment: The incidence of opportunistic illness has declined dramatically, thanks to the availability of prophylaxis and ART. Nevertheless, even among ART recipients in the most recent period assessed, a low CD4 count (<50 cells/mm3) was the strongest predictor of an incident OI, whereas a high viral load (>100,000 copies/mL) was the most important predictor of an opportunistic malignancy. One must not forget that opportunistic illnesses, while rare, continue to occur, particularly among patients presenting late and those on public insurance (a proxy for lower socioeconomic status). Although not new, the finding that a higher viral load is associated with opportunistic malignancies underscores the importance of maintaining virologic suppression while receiving ART."