With realistic gaps in care (e.g. poor retention leading to ART resistance), projections of 20-year outcomes with delayed ART initiation (CD4 ≤350 cells/mm3) rose to 1,285,000 new HIV infections (95% UR 876,000–2,114,000) and 973,000 AIDS-related deaths (95% UR 679,000–1,412,000). Here, CD4 is linked to HIV infectious disease.