Mortality and retention after 12 months in a cohort of patients initiated with the new WHO recommendations in Uganda

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Background: The 2013 WHO guidelines recommend to start ART in all individuals with CD count 500 cells/mm3 or less regardless clinical stage. Evidence for clinical benefit of initiation between 350-500 cells is limited and relies mainly in observational studies from high income countries. Concerns about high risk of defaulting in those patients have also been raised. Here we present data on retention and mortality after 12 months on treatment from a cohort of patients initiated on ART with less than 500 CD4 cells in Uganda as part of a pilot on early ART initiation. Conclusions: Our analysis found decreased mortality in the first year of ART in patients started with a baseline CD4 above 350 cells compared with those initiated with CD4 201-350 cells suggesting that the new WHO recommendations can also have individual clinical benefit in resource limited settings. Retention at 12 months in both groups was similar and above 85%

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