MEDICAL UPDATE: T-cell Counts and T-cell Functioning


MEDICAL UPDATE: T-cell Counts and T-cell Functioning

Being Alive Newsletter; December 1992
Mark Katz MD and reported by Jim Stoecker

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 CD4 count.

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.
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