Long-Term Antiretroviral Therapy Could Restore CD4 Counts in HIV Patients

HIV-infected patients who maintain maximal viral suppression on combination antiretroviral therapy can achieve normal CD4-cell counts, reports a study released early online in Lancet.
The observational study included some 1800 antiretroviral-naive patients who, after starting combination antiretroviral therapy, achieved maximal virologic suppression, defined as at least two consecutive viral loads below 50 copies/mL. The researchers found:
The greatest increases in CD4 counts occurred during the first year of treatment.
Among patients with baseline CD4 counts greater than 350 cells/microliter, counts normalized (at about 800 cells/microliter) after 3 to 5 years of treatment.
Small but significant CD4 increases continued through 5 years of treatment among patients with current counts below 500 cells/microliter.
Editorialists question the generalizability of the findings but conclude that, "at least for patients with ideal responses to [combination antiretroviral therapy], normalisation of CD4 counts is likely to be achievable across a range of baseline counts."