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M94A2791.TXT
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1994-10-25
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Document 2791
DOCN M94A2791
TI Contribution of intravenous immunoglobulins (IVIG) therapy in HIV
infected adults.
DT 9412
AU Mars ME; Quinson AM; North MO; Gallais H; Infectious Diseases Unit,
Hopital La Conception, Marseille,; France.
SO Int Conf AIDS. 1994 Aug 7-12;10(1):224 (abstract no. PB0325). Unique
Identifier : AIDSLINE ICA10/94369784
AB OBJECTIVE: To determine the role of IVIG therapy in HIV infected adults.
METHODS: Between november 1992 and july 1993, 35 patients (12 homosexual
men, 12 intravenous drug users, 9 heterosexual contaminated, 2
transfusion contaminated; 13 women, 22 men; mean age 36.5 years) were
enrolled (group A) in a therapeutic protocol with antiretroviral
treatment associated with IVIG infusions (1 g/Kg each month; 2ml/mn).
Sixteen were asymptomatic (1 with a chronic sinusitis) 14 were
classified as having ARC (4 with a recurrent upper respiratory tract
infection) 5 AIDS (2 with an index of Karnofsky less than 60%). We
matched up each patient with an another patient (group B) with the same
sex, age, mean of contamination, CDC classification (for the same
opportunistic infection), HIV infection history, index of Karnofsky,
recurrent infection, treatment, CD4 cells count, p24 antigenemia titer
and the same beta 2 microglobulinemia titer. Group B did not receive any
infusion. RESULTS: Although only 1 adverse reaction was observed from
the infusion (which led us to stop infusions for this patient) the
protocol was prematurely stopped after 6 cures. In group A we observed a
higher rate of improvement in Karnofsky's index and in recurrent
infections (5 in group A/0 in group B; p = 0.02); but there were more
opportunistic infections (8 in group A/2 in group B; p = 0.04); and more
non opportunistic infections too (7 in group A/0 in group B; p = 0.005).
Four patients died 3 in group A, 1 in group B (p = 0.3). No difference
was noted with respect to biologic parameters during these 6 months.
DISCUSSION AND CONCLUSIONS: Even if IVIG are beneficial for adults with
recurrent upper respiratory tract infection or a low index of Karnofsky
(as among HIV infected children); the choice of this treatment (in
association with an antiretroviral treatment) must be pondered because
of a higher risk of developing an infection (opportunistic or no). The
role of IVIG in HIV infected adults needs to be clarified in larger
comparative trials.
DE Adult Antiviral Agents/THERAPEUTIC USE AIDS-Related Opportunistic
Infections/EPIDEMIOLOGY/ETIOLOGY Case-Control Studies Combined
Modality Therapy Comparative Study Disease Susceptibility Female
Human HIV Infections/DRUG THERAPY/IMMUNOLOGY/*THERAPY Immunoglobulins,
Intravenous/*THERAPEUTIC USE Male Risk Factors Treatment Outcome
CLINICAL TRIAL MEETING ABSTRACT
SOURCE: National Library of Medicine. NOTICE: This material may be
protected by Copyright Law (Title 17, U.S.Code).