Long-term follow-up of HIV-infected individuals who have significant increases in CD4+ cell counts during antiretroviral therapy

Susan L. Koletar, Paige L. Williams, Julia Wu, J. Allen McCutchan, Susan E. Cohro, Robert L. Murphy, Howard M. Lederman, Judith S. Currier

Research output: Contribution to journalArticlepeer-review


Background. Descriptions of the durability and consequences of immune reconstitution in patients who start highly active antiretroviral therapy (HAART) while severely immunosuppressed are limited. Methods. Patients with previous CD4+ cell counts <50 cells/mm3, all of whom had HAART-induced increases in CD4+ cell counts of >100 cells/mm3 on 2 separate occasions (measured sequentially at least 4 weeks apart), were enrolled in a prospective trial and observed every 16-32 weeks. Evaluations included assessments for new opportunistic complications, virologic (human immunodeficiency virus [HIV] RNA load) and immunologic (CD4+ cell count) responses, or death. Results. The median follow-up duration for 612 subjects was 184 weeks (range, 8-216 weeks). The rate of increase in CD4+ cell counts was ∼5.9 cells/mm3 every 8 weeks, with the degree of increase associated with the baseline HIV RNA load (<500 vs. ≥500 copies/mL). Subsequent measurements of virologic suppression based on HIV RNA levels were also associated with predicted CD4 + cell responses. Thirty-three AIDS-defining illnesses were reported (1.75 events per 100 person-years of follow-up); >40% (14 cases) occurred with higher than expected CD4+ cell counts. Conclusions. CD4 + cell count increases are related to virological control, with continuing increases seen in individuals who are immunosuppressed. Opportunistic illnesses and/or complications are infrequent but can occur at any time, even in patients who maintained an elevated CD4+ cell count.

Original languageEnglish (US)
Pages (from-to)1500-1506
Number of pages7
JournalClinical Infectious Diseases
Issue number10
StatePublished - Nov 15 2004

ASJC Scopus subject areas

  • Microbiology (medical)
  • Infectious Diseases


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