Adding raltegravir to suppressive ART did not increase CD4-cell counts or reduce residual viremia more than placebo.
Even after many years of suppressive antiretroviral therapy (ART), a substantial proportion of HIV-infected patients do not achieve normal CD4-cell counts, perhaps because of persistently high levels of T-cell activation or because of low-level residual viremia. To assess whether ongoing HIV replication contributes to persistent activation and suboptimal CD4-cell recovery, investigators conducted a randomized, controlled study of raltegravir intensification.
Thirty patients who had CD4 counts <350 cells/mm3 for ≥1 year despite suppressive ART were randomized to add raltegravir or placebo to their current regimens for 24 weeks. At baseline, the median duration of virologic suppression was 2.6 years, and the median CD4 count was 232 cells/mm3.…