Viral Load and CD4 Count Can Predict Brain Impairment

An HIV viral load that climbs above 30,000 copies or a drop in CD4-cell counts to below 400 in the first year after HIV infection is associated with a six-fold increase in the chances of developing HIV-related neurological impairment, accord to a study in the October edition of Archives of Neurology. The study of 74 HIV-positive adults, for whom seroconversion dates could be determined, showed that patients who had low CD4 counts in the first year after infection were significantly more likely to eventually develop neurological problems than those who maintained counts above 400. A high baseline viral load also was significantly associated with future neurological impairment. Study subjects with both high viral loads and low CD4-cell counts were the most likely to develop neurological symptoms. Because other studies have shown that antiretroviral therapy can slow or prevent the development of such complications, 'patients with high HIV RNA levels and low CD4 counts early after infection should be aggressively treated to prevent immunological decline and cognitive deterioration,' the researchers concluded.