The Incidence of AIDS-Defining Illnesses in 4883 Patients With Human Immunodeficiency Virus Infection

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Abstract
A NATURAL order of acquired immunodeficiency syndrome (AIDS)–defining diseases, defined by the CD4 lymphocyte count, has been suggested in patient populations of various sizes.1-3 Knowledge of the risk of a specific disease according to the level of CD4 lymphocyte counts allows clinicians to screen patients for the most likely diseases, given their CD4 lymphocyte count, and to target prophylaxis at the most relevant population. It is also important to establish if the risk of a particular disease varies according to basic demographic variables, such as age or sex, or if the risk of the disease continues to increase as the CD4 lymphocyte count decreases. A study by Bacellar et al4 reports the incidence of opportunistic infections in patients with CD4 lymphocyte counts below 0.1×109/L (100/mm3), but does not detail the incidence at very low CD4 lymphocyte counts (9/L). Trials of new agents for the prophylaxis of opportunistic infections are increasingly being undertaken. Disease prophylaxis can have a high cost and patients who need prophylaxis are those who require more intensive clinical monitoring. Therefore, it is of great importance to determine the optimal time to initiate prophylaxis and to estimate the cost and benefit obtained from such new interventions.5