Details

Autor(en) / Beteiligte

• STELLBRINK, Hans-Jürgen
• VAN LUNZEN, Jan
• ARIES, Philipp S
• DEGEN, Olaf
• EGGERS, Christian
• PETERSEN, Heiko
• HAAG, Friedrich
• HORST, Heinz A
• DALHOFF, Klaus
• MÖCKLINGHOFF, Christiane
• CAMMACK, Nick
• TENNER-RACZ, Klara
• WESTBY, Michael
• RACZ, Paul
• O'SULLIVAN, Eithne
• SCHNEIDER, Claus
• ADAM, Axel
• WEITNER, Lutwin
• KUHLMANN, Birger
• HOFFMANN, Christian
• FENSKE, Stefan

Titel

Effects of interleukin-2 plus highly active antiretroviral therapy on HIV-1 replication and proviral DNA (COSMIC trial)

Ist Teil von

• AIDS (London), 2002-07, Vol.16 (11), p.1479-1487

Ort / Verlag

Hagerstown, MD: Lippincott Williams & Wilkins

Erscheinungsjahr

2002

Quelle

MEDLINE

Beschreibungen/Notizen

• The effect of interleukin-2 (IL-2) in combination with antiretroviral therapy on HIV-1 replication and reservoirs was investigated. In a prospective, open-label trial, 56 asymptomatic HIV-1-infected subjects (CD4 T cell count > 350 x 10(6) cells/l) were randomized to highly active antiretroviral therapy (HAART: stavudine, lamivudine, nelfinavir, saquinavir) with or without IL-2 (9 megaunits daily for 5 days in 6-weekly intervals for a total of eight cycles). Productive and latent infection were analysed in peripheral blood, and residual virus replication in the lymphoid tissue and in the cerebrospinal fluid. The influence of IL-2 on viral rebound after treatment discontinuation was studied. Virus replication was detected in 21 of 31 on-treatment lymph nodes despite undetectable plasma viraemia. Viral RNA was found in resting as well as in proliferating cells. RNA-negative patients tended towards more rapid proviral DNA elimination. Supplementary IL-2 led to a greater increase in CD4 T cell counts than HAART alone (P < 0.001), resulting in normalization in approximately 90% of IL-2-treated patients compared with approximately 50% HAART-only subjects. IL-2 had no beneficial effect on virus replication and on proviral DNA in peripheral blood. Viral persistence during HAART is partly a result of continued low-level replication, calling for more active regimens. IL-2 accelerates the normalization of CD4 T cell counts but does not impact on virus production or latency.