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Background:

A major goal of antiretroviral therapy (ART) for HIV-1-infected persons is the recovery of CD4 T lymphocytes, resulting in thorough protection against opportunistic complications. Interruptions of ART are still frequent. The long-term effect on CD4 T-cell recovery and clinical events remains unknown.

Methods:

Immunological and clinical endpoints were evaluated in 2491 participants of the Swiss HIV Cohort Study initiating ART during a mean follow-up of 7.1 years. Data were analysed in persons with treatment interruptions (n= 1271; group A), continuous ART, but intermittent HIV-1 RNA at least 1000 copies/ml (n= 469; group B) and continuous ART and HIV-1 RNA constantly less than 1000 copies/ml (n= 751; group C). Risk factors for low CD4 T-cell counts and clinical events were analysed using Cox proportional hazards models.

Results:

In groups A–C, CD4 T lymphocytes increased to a median of 427 …