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Non CD4 related AIDS illness
May 30, 2006

The goal of HAART is to maintain a "healthy' CD4 count and therefore avoid AIDS related infections for many years. Do you expect to see a rise in other diseases from the virus hiding in lymph cells where HAART has no effect (lymphomas for example), nerve cells (dementia and other neuro disorders)in these long term survivors?

Response from Dr. Wohl

The lower level of virus in the body as a whole that occurs with potent HIV therapy is undoubtedly a good thing. The small amounts of remaining virus in some cells is generally not replicating and instead is hanging out waiting for the cell to become active. Therefore, I think such virus poses less of a threat.

I am more concerned about people with high CD4 cells who are not on therapy and have high levels of HIV. That this virus could be doing some nasty things prior to the start of HIV therapy is a worry for me.

Fortunately, it seems like there have been some declines in cancer among HIV+ peopel on HIV therapy. Data for dementia are more complicated to interpret as there are different degrees of dementia and ways to measure and detect it. Overall, I think we are seeing less HIV related dementia and improvements in cognitive disorders when HIV therapy is prescribed.

DW



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