[Evolution of CD4+ T-cell count among AIDS patients in socially unequal contexts]

This study analyzed the evolution in CD4+ T-cell count in AIDS patients in the city of Rio de Janeiro, Brazil, who were on highly active antiretroviral treatment (HAART) at the Municipal Health Centers in the Maré neighborhood, located in a large slum area, and in Copacabana, located in the city's more affluent South Side. Immediately prior to HAART, the median CD4+ T-lymphocyte count was 181 cells/mm(3) in Maré and 182 cells/mm(3) in Copacabana. After 24 weeks of HAART, the median count reached 302 and 315/mm3 in the two health centers, respectively. Following HAART, individuals with AIDS in Maré had 2.8 times the odds of not presenting an immune response as compared to cases in Copacabana (95%CI: 1.1-7.2). Slum residents from Maré had 3.7 the odds of not presenting an immune response as compared to slum residents from Copacabana (95%CI: 1.2-11.5). Males from Maré had 4.4 the odds of not presenting an immune response as compared to those from Copacabana (95%CI: 1.1-18.2). The results suggest a worse prognosis and higher case-fatality for AIDS patients from slums, independently of access to HAART.