New data published in the February 1 edition of the Journal of Acquired Immune Deficiency Syndromes suggest that HIV-positive patients who begin antiretroviral therapy with very low CD4 cell counts have a good chance of quickly achieving and sustaining an undetectable viral load, reports Aidsmap.com (aidsmap.com, 1/31).

Current HIV treatment guidelines recommend that antiretroviral therapy be started when a patient’s CD4 cell count is around 350 cells/mm3. However, in many instances people are not diagnosed with HIV until their CD4 count is well below the recommended threshold.

The researchers from the UK Collaborative HIV Cohort examined 1,117 patients from 10 HIV treatment centers in southeast England and Edinburgh who started treatment with a CD4 cell count below 50 cells/mm3 and a viral load of more than 1000 copies/ml. They found that 12 weeks after beginning treatment, 80 percent of patients had a viral load under 400 copies/ml; at week 48, this percentage rose to 83 percent.

“It is encouraging to note that viral suppression can be achieved fairly rapidly in persons initiating therapy at a severely advanced state of immune deficiency,” conclude the investigators, who add that “these data, albeit under conditions of good infrastructure for care delivery, are a useful comparator for other populations starting therapy at similar levels of immunodeficiency. Such information may be valuable for evaluating the success of antiretroviral therapy in rollout programs.”