Document 2826
 DOCN  M94A2826
 TI    Clinical and immunologic monitoring of HIV-infected patients treated
       with topical dinitrochlorobenzene (DNCB).
 DT    9412
 AU    Stricker RB; Elswood BF; Goldberg B; Henry J; Winger EE; Epstein WL;
       HemaCare Corporation, San Francisco, CA.
 SO    Int Conf AIDS. 1994 Aug 7-12;10(1):216 (abstract no. PB0295). Unique
       Identifier : AIDSLINE ICA10/94369749
 AB    There is growing evidence that HIV infection is controlled by
       cell-mediated immunity (CMI) involving the interaction of dendritic
       cells, Th1 cells, cytotoxic CD8 T-cells and natural killer (NK) cells.
       Dinitrochlorobenzene (DNCB) is a skin sensitizing agent that enhances
       CMI via the induction of delayed-type hypersensitivity. Topical
       application of DNCB was previously shown to be safe in HIV-infected
       patients. In an ongoing pilot study, we have monitored the clinical and
       immunologic status of a group of patients treated with topical DNCB.
       Twenty-four HIV-positive homosexual men were followed for a mean of 28
       months (range, 14-44 months). All subjects were asymptomatic or had
       AIDS-related complex. Initial CD4 T-cell counts ranged from 130/ul to
       600/ul (mean, 353/ul). Ten subjects were taking antiretroviral
       medications (AZT, ddI, ddC), while fourteen were on no antiretroviral
       therapy. Topical DNCB was administered according to the Epstein
       protocol, as previously described (Immunol Letters 1993; 36:1-6).
       Thirteen subjects continued weekly application of DNCB throughout the
       study (the compliant group), while 11 patients discontinued DNCB use
       after 6-24 months (the non-compliant group). Among the 13 compliant
       subjects, two developed an AIDS-defining illness (KS), and both are
       currently in remission. None of the compliant patients died. In
       contrast, 5 of the 11 non-compliant patients developed AIDS (3 PCP, 2
       KS), and four of these patients died. All subjects who developed AIDS
       were on antiretroviral therapy. Compliant subjects showed a significant
       increase in NK cells (mean, 108 +/- 62 to 168 +/- 74, P = 0.002) and
       stable CD8 T-cells (mean, 1014 +/- 570 to 1093 +/- 661, P = NS). In
       contrast, NK cells decreased significantly in the non-compliant group
       (mean, 126 +/- 66 to 70 +/- 31, P = 0.04), while CD8 T-cells decreased
       slightly (mean, 1234 +/- 626 to 920 +/- 527, P = NS). CD4 T-cells
       decreased in both groups, but the drop was significantly greater in the
       non-compliant group (P = 0.03). CD8 CD57 T-cells and CD8 DR T-cells
       increased in the compliant group and decreased in the non-compliant
       group (P = 0.014). CD8 CD38 T-cells increased significantly in both
       groups. We conclude that topical DNCB application on a regular basis is
       associated with a stable clinical course in HIV-infected patients.
       Clinical stability is associated with significantly increased NK cells
       and increased activated and cytotoxic CD8 T-cell subsets. Although CD4
       T-cells decreased in compliant patients, there was a significantly
       greater drop in non-compliant subjects. Topical DNCB application is a
       promising long-term therapy for HIV disease.
 DE    Adjuvants, Immunologic/PHARMACOLOGY/*THERAPEUTIC USE  Administration,
       Cutaneous  AIDS-Related Complex/IMMUNOLOGY/THERAPY
       Dinitrochlorobenzene/PHARMACOLOGY/*THERAPEUTIC USE  Drug Evaluation
       Human  Hypersensitivity, Delayed/CHEMICALLY INDUCED  HIV
       Infections/IMMUNOLOGY/*THERAPY  Immunity, Cellular/DRUG EFFECTS  Killer
       Cells, Natural/DRUG EFFECTS/IMMUNOLOGY  Lymphocyte Subsets/DRUG
       EFFECTS/IMMUNOLOGY  Male  Pilot Projects  Treatment Outcome  MEETING
       ABSTRACT

       SOURCE: National Library of Medicine.  NOTICE: This material may be
       protected by Copyright Law (Title 17, U.S.Code).