Improvement in CD4+ Cell Counts despite Persistently Detectable HIV Load

Abstract

A major goal of antiretroviral therapy for human immunodeficiency virus (HIV) infection should be to keep the viral load undetectable or at least suppressed as fully as possible.^1,2 For patients with detectable viral loads, changes in medication have been advocated on the basis of studies demonstrating that viral load is a surrogate marker for the clinical progression of HIV infection. However, patients who have persistently elevated viral loads despite treatment with highly active antiretroviral agents (generally a protease inhibitor and two reverse-transcriptase inhibitors) have few therapeutic options. There are a limited number of drugs available, and medication cross-resistance, antagonism, and side effects are matters of concern.³