HIV treatment can effectively reduce HIV levels – the viral load – in the blood to ‘undetectable’ or non-detectable levels (that is, a level below which most viral load tests cannot detect HIV). This does not mean that the virus has been completely eradicated from the body, though; reservoirs of HIV DNA (genetic material) in ‘resting’ or latent immune system cells (not in the blood, but in other parts of the body) mean that viral load quickly rebounds if treatment is stopped. Investigators have found that people with HIV who had a CD4 cell count above 500 at the time they started HIV treatment had much smaller ‘reservoirs’ of HIV-infected cells than people who started therapy with lower CD4 cell counts. This suggests there may be a benefit in starting HIV treatment even when the CD4 count is high – 500 or even more. It also provides an area for further research in terms of looking for a cure for HIV.
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