To date, the literaturein low- and middle-income countries has mainly focused on non-RIC among pre-ARTpatients8–10 or patients who start ART with lowCD4 counts (≤350 cells/mm3) and/or at the AIDS stage.11–13 Evidence suggests a lower RIC rate among pre-ART patientswith high CD4 counts,9,10,14 but it is still unknown whether high CD4 counts (>350cells/mm3) at ART initiation will improve or deteriorate RIC. The gene discussed is CD4; the disease is AIDS.