Clinical, virologic, and immunologic effects of combination therapy with ribavirin and isoprinosine in HIV-infected homosexual men.
We evaluated the clinical, immunologic, and virologic effects of oral treatment with ribavirin and isoprinosine for up to 3 months in asymptomatic, HIV-culture-positive homosexual men. Fifteen consecutive men received isoprinosine 4 g/day (1 g q.i.d.), and 800 (9 men) or 1,200 mg/day (6 men) of ribavirin. Five men in each ribavirin dosage group completed at least 2 months of treatment. No unexpected toxicities were observed. Eight minor HIV-related events occurred in six men while on study. All men remained HIV-positive, and time to positive culture decreased by at least 4 days in three men from each treatment group. Serum p24 levels did not change in two men who were p24 antigenemic and received 800 mg/day of ribavirin. Treatment was associated with a generalized lymphopenia affecting all lymphocyte subsets including CD4, which was partially reversible 1 month after stopping treatment. Most of the men remained anergic on DTHS skin testing. No improvements were noted in in vitro lymphoproliferative responses to antigens or in NK cell activity (which decreased significantly in the 1,200 mg/day ribavirin group). Although well tolerated at the doses employed, the combination of ribavirin and isoprinosine produced an unexpected generalized lymphopenia and did not exhibit HIV-suppressive or immunorestorative effects.
Schulof
R S
RS
Division of Hematology and Oncology, George Washington University Medical Center, Washington, D.C. 20037.
Parenti
D M
DM
Simon
G L
GL
Paxton
H
H
Meyer
W A
WA
Schlesselman
S B
SB
Courtless
J
J
LeLacheur
S
S
Sztein
M B
MB
D000328:Adult; D000998:Antiviral Agents / Q000627:therapeutic use*; D015496:CD4-Positive T-Lymphocytes; D006678:HIV / Q000302:isolation & purification; D015658:HIV Infections / Q000188:drug therapy* / Q000276:immunology; D006801:Humans; D007288:Inosine / Q000031:analogs & derivatives*; D007542:Inosine Pranobex / Q000627:therapeutic use*; D007694:Killer Cells, Natural / Q000276:immunology; D007958:Leukocyte Count; D008297:Male; D012254:Ribavirin / Q000627:therapeutic use*; D012263:Ribonucleosides / Q000627:therapeutic use*; D050378:T-Lymphocytes, Regulatory
D000998:Antiviral Agents; D012263:Ribonucleosides; D012254:Ribavirin; D007288:Inosine; D007542:Inosine Pranobex