Long-Term Antiretroviral Therapy Reduces Pneumonia and Shingles Risk in People With HIV

Times Now

Thanks to modern medicine, people living with HIV can now live long and healthy lives. Antiretroviral therapy (ART) has greatly reduced serious HIV-related illnesses by controlling the virus and helping

the immune system recover. However, research shows that some infection risks still remain—especially for people whose immune systems have not fully recovered.A large long-term study followed adults with HIV who were receiving medical care between 2010 and 2023. The researchers looked closely at two common infections: community-acquired pneumonia, a lung infection, and herpes zoster, also known as shingles. They studied how often these infections occurred based on age, CD4 count (a key measure of immune health), and how long people had been on ART.

Why CD4 Count Matters

CD4 cells help the body fight infections. A higher CD4 count means a stronger immune system. The study found that CD4 count plays a major role in infection risk.People with CD4 counts of 200 cells/µL or lower had the highest risk. In this group, pneumonia rates ranged from 34 to 107 cases per 1,000 people per year, while herpes zoster ranged from 9 to 63 cases per 1,000 people per year. Older adults in this group faced even higher risks.These findings show that when the immune system remains weak, the body is still more vulnerable, even with ART.

Lower Risk With Immune Recovery

The good news is that people with HIV who achieved CD4 counts of 500 cells/µL or higher and had been on ART for at least one year had much lower infection rates. In this group, pneumonia occurred at 5 to 20 cases per 1,000 people per year, and herpes zoster at 4 to 5 cases per 1,000 people per year.These rates are similar to those seen in people without HIV. This shows that long-term ART and good immune recovery can greatly reduce infection risk, bringing it close to normal levels.

Vaccination

Vaccines are an important way to prevent infections like pneumonia and shingles. The study suggests that people with HIV who have strong immune recovery may be able to follow the same vaccine guidelines as the general population.However, for people who still have low CD4 counts, ongoing viral activity, or incomplete immune recovery, extra attention is needed. Targeted vaccination strategies may help protect these individuals from preventable infections.