Will You Rebound?

While the majority of HIVers on successful antiretroviral therapy regimens post significant -- even complete -- immune system recovery, not everyone can expect such robust results, warns a study from the journal Clinical Infectious Diseases. Researchers followed for 7.5 years more than 350 HIV-positive men and women who had achieved significant viral suppression through anti-HIV drugs (identified as viral loads held below 1,000 copies for at least four years) and found that the study participants who began treatment with higher CD4-cell counts also achieved the highest CD4 rebounds. Ninety-five percent of participants who began anti-HIV treatment with a CD4-cell count about 300 achieved a 'near normal' count of 500 cells or higher, compared to just 44% of those starting medications with a CD4-cell count under 100 and 25% of those starting therapy with a count between 100 and 200. In some cases, HIVers who began therapy with low T-cell counts did not achieve full immune system recovery after 10 years of otherwise successful antiretroviral treatment. The analysis also showed that the greatest CD4-cell gains occurred within the first four years of treatment, with much slower improvements thereafter. 'Although the majority of patients have evidence of slow CD4-cell count over time, many do not,' the Emory University researchers concluded. 'These individuals may have an elevated risk of non-AIDS-related morbidity and mortality.'