Dissident AIDS Database

CD4+ countsInconsistent surrogate markerCounting reliabilityEffect of HAART
Changes in CD4 lymphocyte counts after interruption of therapy in patients with viral failure on protease inhibitor-containing regimens.
 Youle M et al.
  “Previously published data on CD4 cell count changes during therapy interruptions have mainly consisted of reports on very small numbers, but there has been a tendency to observe a distinct fall in numbers. The relatively rapid early fall in CD4 cell count after interrupting therapy may correspond to the relatively rapid increase in CD4 cell count after initiating therapy, which has been ascribed to the redistribution of cells from the lymphoid tissue [i.e. CD4 cells may not be increased with antiretroviral therapy, merely shuffled around the body to places where they are easier to measure].”
  AIDS. 2000 Aug 18;14:1717-1720.2000
Directly measured kinetics of circulating T lymphocytes in normal and HIV-1 infected humans.
 Hellerstein M et al.
  “This analysis confirms that the rate of removal of CD4+ T cells is indeed elevated and the half-life is indeed shortened in the HAART group" [i.e. therapy might raise the level of CD4+ cell counts, but they are not the same as normal immune cells, and might not be doing any good]”
  Nat Med. 1999 Jan;5(1):83-9.1999
Interview Mohammed Ali Al-Bayati : Are Steroids the Real Cause of AIDS?
 Mark Gabrish Conlan
  "I listed in my book cases of patients who were “HIV-negative” and given AZT, and it increased their CD-4’s short-term."
  Zengers Jan. 20002000
Getting to the HAART of T cell dynamics.
 Roederer, M
  The author argues that the initial rise in CD4 count after starting on antiretroviral medications does not represent any decreased killing of CD4+ T lymphocytes, but rather represents shifting of available cells out of the tissues and into the bloodstream.
  Nature Medicine 4: 145-146.1998
Initial increase in blood CD4(+) lymphocytes after HIV antiretroviral therapy reflects redistribution from lymphoid tissues.
 Bucy RP, Hockett RD, Derdeyn CA, Saag MS, Squires K, Sillers M, Mitsuyasu RT, Kilby JM.
  "Previous studies proposed a dynamic, steady-state relationship between HIV-mediated cell killing and T-cell proliferation, whereby highly active antiretroviral therapy (HAART) blocks viral replication and tips the balance toward CD4(+) cell repopulation. In this report, we have analyzed blood and lymph node tissues obtained concurrently from HIV-infected patients before and after initiation of HAART. Activated T cells were significantly more frequent in lymph node tissue compared with blood at both time points. Ten weeks after HAART, the absolute number of lymphocytes per excised lymph node decreased, whereas the number of lymphocytes in the blood tended to increase... These data provide evidence suggesting that initial increases in blood CD4(+) cell counts on HAART are due to redistribution and that this redistribution is mediated by resolution of the immune activation that had sequestered T cells within lymphoid tissues. "
  J Clin Invest 1999 May 15;103(10):1391-1398.1999