However an accompanying Comment cautions the findings are only applicable to patients having periods of maximum virological suppression, and thus have limited application in low income countries.
Dr Amanda Mocroft, Royal Free Centre for HIV Medicine, Royal Free and University College London Medical Schools, and colleagues did a study of 1835 antiretroviral-naive patients from EuroSIDA, a pan-European observational cohort study. These patients, with a mean CD4 cell count of 204 cells per microlitre of blood, then started cART. They were selected because they all responded well to cART and their HIV viral loads were suppressed to below 50 copies per ml for extended periods of time.
The researchers found that the greatest average yearly increase in CD4 count of 100 cells per microlitre was seen in the year immediately following the start of cART. Significant, but lower, yearly increases of around 50 cells per microlitre were seen even five years after beginning cART in some cases, in which patients whose current CD4 count was below 500 cells per microlitre. Patients starting cART with low CD4 cell counts (of less than 200 cells per microlitre) had substantial rises in CD4 counts even after five years. The only groups without substantial increases in CD4 count were those where cART had been taken for more than five years with a current CD4 count of more than 500 cells per microlitre.
The authors conclude: “Normalisation of CD4 counts in HIV-infected patients for all infected individuals might be achievable if viral suppression with cART can be maintained for a sufficiently long period of time.
“We have shown that most patients with HIV who can maintain viral load at less than 50 copies per ml continue to have significant rises in CD4 counts, even after protracted exposure to combination therapy.
“Patients who started cART with a CD4 cell count of more than 350 cells per microlitre had CD4 cells counts approaching the level seen in HIV-negative individuals after more than three years of cART and had no further significant rises in CD4 counts.”
In the accompanying Comment, Dr Gary Maartens and Dr Andrew Boulle, University of Cape Town, South Africa, point out that CD4 cell count when patients start cART is the most important factor is predicting survival – not count increases after cART has begun.
They say: “Mocroft and colleagues’ findings that CD4 counts continue to increase on cART until normal values are reached, even with low CD4 counts at baseline, is only generalisable to patients on cART during periods of maximum virological suppression.”
They conclude: “Nevertheless, the researchers have shown that at least for patients with ideal responses to cART, normalisation of CD4 counts is likely to be achievable across a range of baseline counts.”
Tony Kirby | alfa
A 'half-hearted' solution to one-sided heart failure
24.11.2017 | Boston Children's Hospital
New study points the way to therapy for rare cancer that targets the young
22.11.2017 | Rockefeller University
High-precision measurement of the g-factor eleven times more precise than before / Results indicate a strong similarity between protons and antiprotons
The magnetic moment of an individual proton is inconceivably small, but can still be quantified. The basis for undertaking this measurement was laid over ten...
Heat from the friction of rocks caused by tidal forces could be the “engine” for the hydrothermal activity on Saturn's moon Enceladus. This presupposes that...
The WHO reports an estimated 429,000 malaria deaths each year. The disease mostly affects tropical and subtropical regions and in particular the African continent. The Fraunhofer Institute for Silicate Research ISC teamed up with the Fraunhofer Institute for Molecular Biology and Applied Ecology IME and the Institute of Tropical Medicine at the University of Tübingen for a new test method to detect malaria parasites in blood. The idea of the research project “NanoFRET” is to develop a highly sensitive and reliable rapid diagnostic test so that patient treatment can begin as early as possible.
Malaria is caused by parasites transmitted by mosquito bite. The most dangerous form of malaria is malaria tropica. Left untreated, it is fatal in most cases....
The formation of stars in distant galaxies is still largely unexplored. For the first time, astron-omers at the University of Geneva have now been able to closely observe a star system six billion light-years away. In doing so, they are confirming earlier simulations made by the University of Zurich. One special effect is made possible by the multiple reflections of images that run through the cosmos like a snake.
Today, astronomers have a pretty accurate idea of how stars were formed in the recent cosmic past. But do these laws also apply to older galaxies? For around a...
Just because someone is smart and well-motivated doesn't mean he or she can learn the visual skills needed to excel at tasks like matching fingerprints, interpreting medical X-rays, keeping track of aircraft on radar displays or forensic face matching.
That is the implication of a new study which shows for the first time that there is a broad range of differences in people's visual ability and that these...
15.11.2017 | Event News
15.11.2017 | Event News
30.10.2017 | Event News
24.11.2017 | Physics and Astronomy
24.11.2017 | Health and Medicine
24.11.2017 | Earth Sciences