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Hiv rebound inevitable?
May 26, 2003

If with the consent of one's doctor, one stops haart with good cd4 cells (600-700) and undetectable vl, is it always inevitable that vl will rebound to very high levels and much faster than it was before on haart? Is it at all possible that improved health, diet, care may actually lower the replication rate?

Thanks!

Response from Dr. Henry

A small percentage of persons who stop HIV therapy don't get a rebound in viral level. Most of those persons have been those who were treated very early after their initial HIV infection. For most situations, the viral load tends to settle towards their pre-treatment HIV level. I have seen no convincing evidence (either published or with my own patients) that good general health or diet minimizes that rebound. The absence/or treatment of other active serious infections (such as herpes or TB) may decrease the overall HIV replication rate in some cases. KH



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