HIV Digest	HIV Digest Archive

A Swiss study of the medical records of 98 patients treated for 48 weeks found substantial increases in CD4 count even for those whose viral load never became undetectable. The patients whose treatment was interrupted had a much smaller CD4 benefit. These results add to the suggestions from elsewhere that highly active antiretroviral treatment can provide benefit even if the virus is not completely suppressed.

When they started treatment, the 98 patients had a CD4 count baseline averaging about 162-- and about 66 percent of them did not have complete suppression of their viral load. All had extensive prior treatment with antiretrovirals such as AZT. Eighty two took a protease-inhibitor-containing regimen continuously for the 48 weeks; the other 16 had interruptions in treatment averaging 55 days.

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Those whose virus became persistently undetectable had a CD4 increase of 138. Those whose virus only transiently became undetectable had an increase of 132. Those who took therapy continuously despite never achieving undetectable viral load had an average increase of 105.

The 16 patients who interrupted therapy had an average CD4 increase of 57.

This study does not answer the question of whether the still-replicating virus will be able to become more resistant later and fully negate the value of the drugs-- or whether the drug-resistant virus is damaged or less pathogenic in some way, allowing the treatment to be of value indefinitely even if undetectable viral load is not reached or maintained. Clearly long-term data will be needed.

Editor's Note: from AIDS Treatment News