Intensification of Antiretroviral Therapy — No Demonstrable Benefit

Achieving the expressed goal of antiretroviral therapy — suppression of viral load to below the level of detection (usually to <50 copies of RNA/mL of plasma) — generally leads to significant gains in clinical well-being and in CD4 lymphocytes. However, some patients do not achieve substantial CD4-cell increases despite virologic suppression, and intensifying therapy with an additional agent has been suggested as a way to enhance these patients' CD4-cell recovery. Unfortunately, this approach does not seem to work, as indicated by two studies at the 2010 Conference on Retroviruses and Opportunistic Infections.

In a single-arm AIDS Clinical Trials Group pilot study, 34 patients with suppressed viral loads but insufficient CD4-cell recovery ad…