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

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