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M9550080.TXT
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1995-03-04
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Document 0080
DOCN M9550080
TI Increases in CD4 T lymphocytes with intermittent courses of
interleukin-2 in patients with human immunodeficiency virus infection. A
preliminary study.
DT 9505
AU Kovacs JA; Baseler M; Dewar RJ; Vogel S; Davey RT Jr; Falloon J; Polis
MA; Walker RE; Stevens R; Salzman NP; et al; Critical Care Medicine
Department, Warren Grant Magnuson Clinical; Center, Bethesda, Md.
SO N Engl J Med. 1995 Mar 2;332(9):567-75. Unique Identifier : AIDSLINE
MED/95140063
AB BACKGROUND. Interleukin-2 is an important regulatory cytokine of the
immune system, with potent effects on T cells, B cells, and natural
killer cells. In vitro, interleukin-2 can induce the proliferation and
differentiation of peripheral-blood mononuclear cells from patients
infected with the human immunodeficiency virus (HIV). METHODS. We
treated 25 HIV-infected patients with interleukin-2 administered as a
continuous infusion at a dosage of 6 to 18 million IU per day for 5 days
every 8 weeks during a period of 7 to 25 months. All patients also
received at least one approved antiviral agent. Immunologic and
virologic variables were monitored monthly. RESULTS. In 6 of 10 patients
with base-line CD4 counts higher than 200 per cubic millimeter,
interleukin-2 therapy was associated with at least a 50 percent increase
in the number of CD4 cells. Changes ranged from -81 to +2211 cells per
cubic millimeter. Interleukin-2 therapy resulted in a decline in the
percentage of CD8 lymphocytes expressing HLA-DR and an increase in the
percentage of CD4 lymphocytes that were positive for the p55 chain of
the interleukin-2 receptor. Four patients had a transient but consistent
increase in the plasma HIV RNA level at the end of each infusion. In the
remaining 15 patients, who had CD4 counts of 200 or fewer cells per
cubic millimeter, interleukin-2 therapy was associated with increased
viral activation, few immunologic improvements, and substantial toxic
effects. CONCLUSIONS. Intermittent courses of interleukin-2 can improve
some of the immunologic abnormalities associated with HIV infection in
patients with more than 200 CD4 cells per cubic millimeter.
DE Adult CD4 Lymphocyte Count *CD4-Positive T-Lymphocytes Dose-Response
Relationship, Immunologic Female Human HIV
Infections/*IMMUNOLOGY/*THERAPY Interleukin-2/ADMINISTRATION &
DOSAGE/*THERAPEUTIC USE Male Middle Age Support, U.S. Gov't, P.H.S.
CLINICAL TRIAL JOURNAL ARTICLE
SOURCE: National Library of Medicine. NOTICE: This material may be
protected by Copyright Law (Title 17, U.S.Code).