Treatment Interruption in Patients with Pre-ART CD4 Counts >350 Cells/mm3

Patients with nadir CD4 counts >350 cells/mm³ who underwent treatment interruption had a low rate of clinical HIV progression. However, the occurrence of five deaths during the study raises important questions about the safety of this strategy.

When potent combination antiretroviral therapy (ART) was first introduced, many HIV-infected patients started treatment at higher CD4-cell counts than is currently recommended. Whether such patients can now safely interrupt therapy is questionable.

ACTG investigators evaluated the safety of a 96-week treatment interruption among 167 patients who had been receiving ART (≥2 drugs) for at least 6 months. At enrollment, patients were required to have CD4 counts >350 cells/mm³ (median, 833 cells/mm³) and viral loads <55,000 copies/mL. They were also required to have CD4 counts >350 cells/mm³ immediately before their first ART; 23 patients (14%) had prior nadir CD4 counts <350 cells/mm³ (median nadir for all patients, 436 cells/mm³). The primary e…

Reviewing Author

Keith Henry, MD

Treatment Interruption in Patients with Pre-ART CD4 Counts >350 Cells/mm³

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Reviewing Author