Comments on: predictors of immune recovery and the association with late mortalty while on antiretroviral treatment in Cambodia.

Abstract

We read with great interest the article by van Griensven and Thai, who report on the risk factors for late mortality after antiretroviral therapy (ART) initiation in a cohort of 2840 patients in Cambodia. The main risk factor identified was time-updated CD4 cell count, which is consistent with the findings of other studies in different settings. They also analysed predictors of immune recovery, including the use of different non-nucleoside reverse transcriptase inhibitors (NNRTI). Their analysis showed a negative effect of the use of nevirapine (NVP) versus efavirenz (EFV) on CD4 recovery over time. This finding is very interesting as it is contradictory to other reports, including a randomised open-label trial and a meta-analysis.