Despite CD4 cell count rebound the higher initial costs of medical care for HIV-infected patients persist 5 years after presentation with CD4 cell counts less than 350 μl.

We determined that for HIV patients presenting with CD4 cell counts less than 350 μl the initial higher costs of care persisted over 5 years. Fifty-nine percent of new patients between 1 April 1998 and 1 April 2003 had CD4 cell counts less than 350 μl. Mean first year total costs ($19 917 $Cdn) were 2.5 times higher than for presentations with CD4 cell counts more than 350 μl ($7840). Total annual costs of care subsequently decreased to $15 663 by year 5, but still remained higher ($8883) than those with CD4 cell counts more than 350 μl despite a median CD4 cell count increase from 134 to 464 μl.