Document 0224
 DOCN  M9460224
 TI    Immunologic and virologic effects of glucocorticoids on human
       immunodeficiency virus infection in children: a preliminary study.
 DT    9408
 AU    Ferdman RM; Church JA; Childrens AIDS Center, Childrens Hospital Los
       Angeles, CA.
 SO    Pediatr Infect Dis J. 1994 Mar;13(3):212-6. Unique Identifier : AIDSLINE
       MED/94232703
 AB    The immune dysfunction in human immunodeficiency virus (HIV) infection
       is complex and cannot be explained solely on the basis of numerical
       depletion of T lymphocytes. Inappropriate, uncontrolled activation of
       the immune system may be involved. In a test of this hypothesis, five
       HIV-infected children were prospectively treated with prednisone and
       selected immunologic and virologic indices were analyzed. Subjects had
       marked T lymphopenia (CD4+ T lymphocytes < 500 cells/ml) and antigenemia
       (serum p24 antigen > 30 pg/ml) and were free of opportunistic
       infections. There was a significant drop in serum p24 antigen
       concentrations from baseline (60.2 +/- 10.1% SEM; P < 0.005) 4 weeks
       after initiation of prednisone, which returned to baseline
       concentrations as the prednisone was tapered. Concomitant with this
       decrease, there was decreased expression of cell surface activation
       markers (HLA-DR, CD25 (interleukin 2 receptor) and CD26 (Ta-1)) in
       peripheral T lymphocytes. There was no significant change in either T
       lymphocyte subset numbers or mitogen and antigen-specific
       lymphoproliferation. A regulatory dysfunction of the immune system,
       allowing inappropriate activation of T lymphocytes, may be involved in
       the pathogenesis of HIV disease, and further studies involving selective
       immunosuppression in HIV disease are warranted.
 DE    Child  Child, Preschool  CD4-CD8 Ratio  Human  HIV Core Protein
       p24/*BLOOD  HIV Infections/*IMMUNOLOGY/MICROBIOLOGY  Leukocyte Count
       Lymphocyte Transformation  Phenotype  Prednisone/*PHARMACOLOGY
       Prospective Studies  T-Lymphocyte Subsets/*IMMUNOLOGY  T4
       Lymphocytes/*IMMUNOLOGY  JOURNAL ARTICLE

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