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

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