Immune reconstitution in the first year of potent antiretroviral therapy and its relationship to virologic response

The effects of 1 year of zidovudine, lamivudine, and ritonavir treatment on immune reconstitution were evaluated in 34 human immunodeficiency virus (H IV)-infected individuals. After 48 weeks of therapy, 20 (59%) subjects had <100 copies HIV RNA/mL. CD4(+) T cells increased from a median of 192/mm(3) at baseline to 362/mm(3) at week 48, Lymphocyte proliferative responses to Candida normalized within 12 weeks, but responses to HIV and tetanus remai ned depressed throughout therapy. Alloantigen responses increased within 12 weeks and then declined to baseline levels. Recovery of delayed-type hyper sensitivity responses occurred after 12 weeks for Candida and after 48 week s for mumps. The magnitude of virologic suppression was correlated with num eric increases in CD4(+) T cells, but not with measures of functional immun e reconstitution, Plasma virus suppression <100 copies/mL was not significa ntly correlated with increases in CD4(+) T cells or functional immune recon stitution.