Opposing Disease Indicators Are Bad News

HIV-positive adults who experience a discordant response to antiretroviral therapy'having either a fall in HIV viral load or a rise in CD4-cell count but not both'could be at a higher risk for AIDS-related complications and death. Canadian researchers reported in the November 1 edition of the Journal of Acquired Immune Deficiency Syndromes that after six months of therapy, HIVers who post only a drop in HIV viral levels to less than 500 or have only an increase in CD4-cell count to at least 50 cells were up to 21/2 times more likely to die than those responding fully to treatment. Patients with no response at all to treatment were nearly 31/2 times more likely to die. Overall, only 56% of the HIVers studied were complete responders; 15% posted only drops in viral loads, 12% experienced only CD4-cell increases, and 17% had neither. While many clinicians gauge responses to anti-HIV drug therapy by looking primarily at HIV viral levels, the researchers say their findings show that CD4-cell counts should be closely followed as well.