"HAART" stands for Highly Active Anti-Retroviral Therapy. More mainstream
HAART 'attackers' or critics from within the AIDS Industry and from their
own research...

In the 1/2/04 journal AIDS, an article entitled "Impact of 5 years of
maximally successful highly active antiretroviral therapy on CD4 cell
count and HIV-1 DNA level," Viard et al. state:

"It is more and more difficult to imagine anti-HIV treatments as
life-long prescriptions, given the side effects described in the long
terms, such as lipodystrophy (found here in nearly 60% of patients),
metabolic disturbances, a possibly increased cardiovascular risk,
mitochondrial toxicity and altered quality of life. In other words, the
inconvenience of a very-long-term treatment may outweigh the benefit of
maintaining the CD4 cell count at a high level, considering that
treatment beyond 2 to 4 years will not result in a significant reduction
of the HIV-1 DNA load."

"In summary, the data presented here show that HIV-1 DNA does not seem
influenced by HAART after the third year and confirm that the CD4 cell
count gain is less apparent after 18 months on treatment. Based on these
observations, we question the benefits of a life-long treatment for HIV
infection."

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AIDS: Volume 18(1) 2 January 2004 pp 45-49

Impact of 5 years of maximally successful highly active antiretroviral
therapy on CD4 cell count and HIV-1 DNA level

Viard, Jean-Paula,c; Burgard, Marianneb,c; Hubert, Jean-Baptisted;
Aaron, Laurenta; Rabian, Cecili; Pertuiset, Nathaliec; Lourenħo,
Mariab; Rothschild, Chantalc; Rouzioux, Christineb,e

From the aService d'Immunologie Clinique, bLaboratoire de Virologie,
cCentre de Traitement de l'Hemophilie, Centre Hospitalier Universitaire
Necker-Enfants Malades, Paris, dINSERM U569, Hopital de Bicetre, Bicetre
and eEA MRT 3620, Universite Rene-Descartes, Faculte de Medecine
Necker-Enfants Malades, Paris, France.

Requests for reprints to: Dr Jean-Paul Viard, Service d'Immunologie
Clinique, Hopital Necker, 149, rue de Sevres, 75743 Paris Cedex 15,
France.

Received: 15 January 2003; revised: 2 May 2003; accepted: 23 June 2003.

Abstract: Objectives: To evaluate the impact on CD4 cell count and HIV-1
DNA level in peripheral blood mononuclear cells (PBMC) of long-term highly
active antiretroviral therapy (HAART) in the setting of maximal success,
i.e., constant plasma HIV-1 RNA load suppression.

Design: Retrospective analysis of patients selected for a constantly
undetectable plasma HIV-1 RNA load since HAART initiation.

Methods: HIV-1 DNA was measured in PBMC using a real-time polymerase chain
reaction assay. Loess estimates and regression analysis were used for
modelling the variations of the CD4 cell count and HIV DNA level over
time.

Results: The study included 41 patients chronically infected with HIV-1
who had been taking HAART for a median duration of 60.4 months and had an
undetectable plasma HIV RNA load ever since the first 6 months of HAART;
25 were tested for HIV-1 DNA. The mean CD4 cell count increase was high
during the first 18 months on therapy (168 X 10(6) cells/l per year), much
lower afterwards (38 X 10(6) cells/l per year),
independently of the baseline CD4 cell count. Most of the patients (73.2%)
reached a CD4 cell count constantly >= 400 X 10(6)/l during follow-up.
HIV-1 DNA showed a mean decrease of 0.48 log10 copies/10(6) PBMC during
the first year, of 0.18 log10 copies/10(6) PBMC per year during the 2nd
and 3rd years, but no significant decrease afterwards.

Conclusions: These results question the benefit of very long-term
maintenance of HAART in terms of CD4 gain and HIV-1 DNA reduction.