Study Says CD4 Counts May Stay Low on Successful HAART

A study of more than 2,200 HIV-positive patients in Switzerland shows that after four years of highly active antiretroviral therapy, only 39% have CD4-cell counts above 500. Published in the October 13 edition of the Archives of Internal Medicine, the study also showed that 16% of people on HAART still had CD4 counts so low that they were at risk of developing AIDS-related opportunistic infections. Low CD4 counts were most common in individuals who took treatment breaks, had viral loads above 400 copies at least one quarter of the time, and were older study subjects. Among study subjects who took treatment breaks, only 29.4% achieved CD4 counts above 500, and more than one quarter had counts below 200, which is an AIDS-defining condition. However, a study in the September 5 edition of the journal AIDS suggests that CD4 counts can still continue to slowly climb after four years of successful antiretroviral treatment regardless of how low CD4 levels were when the drugs were first started. The study is the first to find no evidence of a plateau in CD4 gains in HIV-positive adults who began anti-HIV drug therapy with CD4 counts below 200, suggesting that the immune system is able to slowly and continuously repair itself even after severe HIV-related damage.