Clinical and immunologic response without decrease in virus load in patients with AIDS after 24 months of highly active antiretroviral therapy

This study reports an analysis of clinical, virological, and immunologic ou tcomes in a cohort of 77 multidrug-experienced AIDS patients during 24 mont hs of highly active antiretroviral therapy (HAART). Our results have shown a reduced risk of AIDS complications, prolonged survival, and immunologic b enefit even in the absence of sustained virus suppression. The degree of im munodepression, the risk factors for HIV-1 infection, the use of 2 drugs in stead of 3, and a change in protease inhibitor were independently correlate d with virological failure. In the majority of studied patients, an increas e in CD4(+) T cells was observed after HAART However, the increase was more pronounced in patients who showed a decrease in virus load than in those w ho did not. Moreover, we observed an absence of relapses among patients who permanently discontinued prophylaxis for Cytomegalovirus retinitis and aty pical mycobacterial infections. Peripheral lipodystrophy developed in the m ajority of patients, regardless of treatment used and virological outcome.