Being Alive 1992 Dec 5: 4
The T-cell count has become the most widely used surrogate marker for
the efficacy of an antiviral. One of the issues with antiviral
therapy, however, is that in general T-cell counts rise for the first
six months (at best) of antiviral use and then drop back to the level
when therapy began (known as baseline).
Does this mean that the antiviral is no longer effective? What about
the functioning of the T-cells? Count, after all, is only a number and
does not tells us how the T-cells are working. Some of the antiviral
efficacy has to be measured by functional improvement.
A recent study in the Journal of Infectious Diseases addressed this
very important point. Researchers studied a group of twelve
asymptomatic and four symptomatic people with HIV. All were treated
with AZT; treatment course averaged 140 weeks for the asymptomatic
group and 89 weeks for the symptomatic group.
The researchers found that 75% of the participants in both the
symptomatic and asymptomatic groups showed a fourfold increase in the
functioning of their T-cells. In contrast, such an increase was found
in only 7.4% of those in an untreated control group.
The researchers further reported that evidence of this improved T-cell
functioning was seen as early as a few weeks after antiviral therapy
began. They also found no correlation between T-cell functioning and
The study provides some more information to counter the argument that
antivirals are not worth taking because they do not sustain the rise
in T-cell count. Efficacy, after all, may not be seen just in higher
T-cell counts. Quality, not just quantity, needs to be considered.