▁CD 4 ▁cell ▁counts ▁have ▁come ▁to ▁the ▁following ▁conclusion : ▁Tre at ment - ex per ien ced ▁patients ▁who ▁start ▁N VP - based ▁combination ▁ther apy ▁with ▁low ▁pre – ART ▁and ▁high ▁current ▁CD 4 ▁cell ▁counts ▁and ▁an ▁und et ect able ▁V L ▁have ▁a ▁similar ▁lik elihood ▁for ▁dis continu ing ▁N VP ▁ther apy ▁because ▁of ▁hyp ers ens itivity ▁re actions ▁( H SR s ), ▁compared ▁with ▁treatment - na ive ▁patients ▁with ▁low ▁CD 4 ▁cell ▁counts . ▁This ▁suggests ▁that ▁N VP - based ▁combination ▁ther apy ▁may ▁be ▁safely ▁initi ated ▁in ▁such ▁patients . ▁However , ▁in ▁similar ▁patients ▁with ▁a ▁detect able ▁V L , ▁it ▁is ▁pr udent ▁to ▁continue ▁to ▁ad here ▁to ▁current ▁CD 4 ▁cell ▁count ▁th resh olds . ▁The ▁U . S . ▁Public ▁Health ▁Service ▁Task ▁Force ▁advoc ates ▁ca ution ▁in ▁the ▁use ▁of ▁ne vi rap ine ▁in ▁pre gn ancy ▁due ▁to ▁to x icity ▁issues , ▁which ▁may ▁be ▁ex ac erb ated ▁during ▁pre gn ancy . ▁ ▁C ases ▁of ▁imm une ▁reconst itution ▁synd rome ▁and ▁fat ▁red ist ribution ▁have ▁also ▁been ▁observed ▁with ▁this ▁drug . ▁ ▁The ▁U . S . ▁Food ▁and ▁D rug ▁Administration ▁recomm ends ▁stopping ▁ne vi rap ine ▁if ▁a ▁person ▁experiences : ▁ ▁sign ▁and ▁sympt oms ▁of ▁li ver ▁issues ▁such ▁as ▁he pat itis ▁ ▁increased ▁trans amin ases ▁in ▁addition ▁to ▁r