Confirming the Benefits of Early Treatment of HIV

Although most HIV-infected patients receiving antiretroviral therapy (ART) achieve an undetectable viral load, many do not attain a normal CD4-cell count. To assess how timing of ART initiation affects CD4-cell recovery, investigators evaluated immune reconstitution in 1199 HIV-infected U.S. Military HIV Natural History Study participants who had achieved an undetectable viral load (median pre-ART CD4-cell count, 358 cells/mm³). CD4-cell normalization was defined as achieving a count of >900 cells/mm³ (based on values from HIV-uninfected persons).

After virologic suppression for a median of 4.7 years, only 31% of participants achieved CD4-cell normalization. Normalization was significantly more common in patients who had initiated ART within…