Additionally, prophylaxis was tried with antifungal agents like ezythromycin against a broad range of fungal infections such as Cryptococcal meningitis. However, since many people are now experiencing T cell rebound and apparent viral suppression, some are now questioning taking what may seem superfluous medication. Since the helper cells are no longer bound up in antigen recognition and immune stimulation in the lymphatic system, they are able to circulate and thus be counted in the peripheral blood. Such a rise in absolute CD4 cells would then not be indicative of a gain in immune function. On the other hand, evidence is starting to emerge that an extended, continued rise in CD4 cells is due to the generation of new cells and an expanded immune reprotoire.
T cells take their name.
An interesting parallel to the current dilemma can be drawn to organ transplant recipients. Cyclosporin A is an immune suppressive drug that is routinely administered to people following organ transplant surgery and was thought necessary to be taken for life to prevent rejection of the donor organ. However, some patients, for whatever reason, just quit taking the drugs and contrary to the prevailing conventional wisdom did not reject their transplants. Nevertheless, this parallel can not be extrapolated directly to HIV OI prophylaxis. While there is almost never a case of MAC in people with a T cell count over 100, there have been a disturbing number of cases of PCP in people with T cell counts well over 200 and no discernable viral load.