the impact of prescribed opioids on cd4 cell count recovery among hivinfected patients newly initiating antiretroviral therapy objectives certain prescribed opioids have immunosuppressive properties yet their impact on clinically relevant outcomes including antiretroviral therapy art response among hivinfected patients remains understudiedmethods using the veterans aging cohort study data we conducted a longitudinal analysis of 4358 hivinfected patients initiating art between 2002 and 2010 and then followed them for 24 months the primary independent variable was prescribed opioid duration categorized using pharmacy data as none prescribed shortterm 90 days and longterm 90 days outcomes included cd4 cell count over time analyses adjusted for demographics comorbid conditions art type and year of initiation and overall disease severity ascertained with the veterans aging cohort study vacs index sensitivity analyses examined whether effects varied according to baseline cd4 cell count achievement of viral load suppression and opioid properties ie dose and known immunosuppressive propertiesresults compared to those with none patients with shortterm opioids had a similar increase in cd4 cell count mean rise per year 74 vs 68 cellsl p 011 as did those with longterm prescribed opioids mean rise per year 74 vs 75 cellsl p 098 in sensitivity analysis compared with no opioids the effects of shortterm prescribed opioids were statistically significant among those with a baseline cd4 cell count 500 cellsl mean rise per year 52 cellsl for no opioids vs 20 cellsl for shortterm opioids p 004 findings were otherwise unchangedconclusions despite immunosuppressive properties intrinsic to opioids prescribed opioids appeared to have no effect on cd4 cell counts over 24 months among hivinfected patients initiating art