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Long-term Non-progression of HIV Disease without Antiretroviral Treatment Is Uncommon

Less than 1% of people infected with HIV for 15 years did not experience disease progression in the absence of antiretroviral therapy (ART), according to findings from the CASCADE cohort reported at the XVIII International AIDS Conference (AIDS 2010) last month in Vienna. Even at 5 years after seroconversion, all but 10% progressed to the point of requiring treatment, and only 0.25% were considered HIV controllers with sustained undetectable viral load.

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Viral Load Increase and CD4 Cell Loss Closely Linked in Untreated People with HIV

Higher viral load was associated with greater CD4 cell decline among HIV positive people not on antiretroviral therapy, according to a report in the June 19, 2010 issue of AIDS. Individuals with HIV RNA levels less than 1000 copies/mL did not experience appreciable annual decreases in CD4 count, while those with viral loads of about 300,000 copies/mL or more lost an average of 159 cells/mm3 per year.

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CROI 2009: ESPRIT and SILCAAT Studies Find No Long-term Benefits of IL-2

Effective antiretroviral therapy (ART) that suppress HIV replication typically leads to increased CD4 cell counts, and ample data clearly shows that it reduces the risk of AIDS-related illness and death. Some individuals on do not experience adequate CD4 T-cell recovery, however, and researchers have therefore explored other potential methods of restoring immune function. 

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CROI 2010: Even Low-level, Short-term Detectable Viral Load Raises the Risk of Virological Treatment Failure and Death

People with HIV who have persistent episodes of low-level viremia are more likely to experience sustained virological rebound and have a higher risk of death than individuals who maintain consistently undetectable viral load (< 50 copies/mL) or experience only transient "blips," according to a poster presented at the 17th Conference on Retroviruses & Opportunistic Infections (CROI 2010) last month in San Francisco.

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Premature Aging of CD4 Cells May Accelerate HIV Disease Progression

Despite extensive research over the past 3 decades, the mechanisms underlying HIV disease progression are still not fully understood. But a report in the January 7, 2009 Journal of Acquired Immune Deficiency Syndromes adds another piece to the puzzle.

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