Viral Load and CD4-Cell Decline: Strongly Linked

When the relationship between higher viral load and greater CD4-cell decline was first described in the Multicenter AIDS Cohort Study nearly 15 years ago, the finding was revelatory — finally, a way to predict the pace of CD4-cell decline and the risk of developing AIDS, even for those with relatively high CD4-cell counts (JW AIDS Clin Care Jul 1 1996). However, subsequent analyses have not all supported this association (JW AIDS Clin Care Oct 23 2006).

Now, investigators at a London HIV clinic have revisited the topic, using data collected from 1169 patients before they started antiretroviral therapy. The cohort was representative of individuals receiving care in the U.K. (i.e., mostly men who have sex with men and also a substantial number…