Long-Term Immunological Response in HIV-Infected Subjects Receiving Potent Antiretroviral Therapy [Kaufmann GR, et al. AIDS 2000; 14: 1959]: This cohort study from Australia involved 135 HIV-infected patients who were treated with HAART beginning in 1996 - 98, whose subsequent increases in CD4 cell counts were analyzed. The median rise after initiating therapy was 20/mm³/month for the first three months and then 7/mm³/month for the follow-up period of an additional 21 months. As expected, the increases correlated with the extent of viral suppression. The median increase between the 4th and 24th month for those with undetectable virus was 9/mm³/month. For those with viral loads of <10,000 copies/mL it was 6/mm³/month, and for those with viral loads >10,000 copies/mL, it was 2.5/mm³/month.
Comment: While there are no surprises here, the enormous variations between subjects is of note. In fact, the authors reported that 19% of patients who achieved undetectable virus had a plateau in the CD4 cell count after one year, suggesting that some may never reach normal CD4 cell counts. posted 7/19/2000