Suboptimal CD4-Cell Recovery Despite Suppressive ART: One Step Closer to An Explanation

CD4-cell counts fail to normalize in a substantial minority of HIV-infected patients on suppressive antiretroviral therapy (ART). Now, an in-depth immunologic analysis suggests a possible unifying mechanism for such failure.

Researchers compared 60 patients with immunologic failure to 188 patients with immunologic success (20 who underwent detailed immunologic testing and another 168 who had clinical information available). Immunologic failure was defined as having CD4 counts <350 cells/mm³ — and immunologic success as having CD4 counts >500 cells/mm³ — after at least 24 months of undetectable viral loads.

Compared to patients with immunologic success, those with immunologic failure:

• Were more likely to be male (81% vs. 70%)

• Were older at the t…