Myelosuppression is the most common cause of reduced RDI, and the increases in neutropenia among WLHIV, despite access to granulocyte colony stimulating factors, may explain some of the reduction seen here.40 Myelosuppression with chemotherapy may not only affect survival by reducing RDI; decreases in circulating CD4 cell count after cancer therapy have been independently associated with increased mortality among patients with cancer living with HIV.41 This evidence concerns the gene CD4 and myelosuppression.