Strategies for HIV therapy

April 2008    View PDF    En español

Why use anti-HIV therapy?

When you’re first infected with HIV, high levels of HIV replication often occur with flu-like symptoms and a decline in the number of CD4+ cells. CD4s are key cells in your immune system that maintain and direct responses against disease. They are also commonly used to measure your immune health.

Without using HIV therapy, your immune system dramatically but incompletely suppresses the virus. In most cases, CD4s return partially toward normal levels and people usually regain good health for many years. Yet, during this time an aggressive battle is waged daily between your immune system and HIV. Over time, the immune system becomes overwhelmed by HIV’s rapid and constant activity.

The relationship between your HIV levels and risk of disease progression is complicated. An influential study by John Mellors found a solid relationship between HIV levels and risk of death over time. Other research suggests that CD4+ counts better predict the risk of disease progression. However, it is well established that reducing HIV levels typically leads to a stronger immune system and better health.

Considering these points, it makes sense to slow down or stop HIV replication as much and for as long as possible. All approved HIV drugs significantly reduce HIV levels, and they almost always cause some rise in CD4+ counts. Lower viral loads and higher CD4+ counts indicate some improvement in your immune system.