Co-infections like hepatitis B, hepatitis C, TB and pneumonia, among others, can cause a transient increase (which is called a blip) in the viral load and decrease the
CD4 cell count, thus lowering the body's ability to kill the co-infecting bacteria or virus.
The introduction of ART has drastically changed the prognosis of HIV infected patients, in terms of decreasing mortality rate and decreasing incidences of opportunistic infections (OIs).The effect of ART is also well established for surrogate-markers such as the viral load and
CD4 cell count (4).
The key to reducing the mortality from Cryptococcal meningitis, which is a consequent of crag positivity, is early diagnosis of crag in ART-naive AIDS patients prior to initiation of ART therapy and the integration of both ART therapy and primary prophylaxis with Fluconazole; this has been shown to reduce mortality from Cryptococcal meningitis consequent of crag positivity even at
CD4 cell count within the range of <100 cells/[micro]l.
Investigators therefore conduced a meta-analysis of studies examining trends in baseline
CD4 cell counts and viral load set-points.
The SMART trial enrolled 5,472 HIV-positive adults with
CD4 cell counts of at least 350 cells/[mm.sup.3] at study inception.
Antibodies carrying fluorescent tags latch onto
CD4 cells in the blood.
Also, they recorded a higher parasitaemia compared to those with CD4 higher than 200 cells/[micro]l, this possibly could be due to the fact that the
CD4 cells which play a central role in the immune defence against many pathogens have been depleted by the HIV virus.
Preclinical studies showed the feasibility of the approach in normal
CD4 cells and in
CD4 cells taken from 20 early- and late-stage patients.
A better understanding of this problem may allow scientists to find a way to enable HIV-specific
CD4 cells to do their job in controlling this virus, as
CD4 cells do with other viruses.
Initially, the researchers identified CD8 cells, which are involved in the autoimmune process and are supposedly responsible for destroying
CD4 cells in the immune system.
*The
CD4 cell is one of the body's main lines of defence against infectious diseases.
The proportion of
CD4 cells normally exceeds that of CD8 cells.