Passive immunotherapy in AIDS: a randomized trial of serial human immunodeficiency virus-positive transfusions of plasma rich in p24 antibodies versus transfusions of seronegative plasma.
To assess the place of passive immunotherapy in the treatment of AIDS, a randomized study was conducted that evaluated the safety and short-term efficacy of serial transfusions of human immunodeficiency virus type 1 (HIV-1) seropositive plasma in 18 patients. Heat-inactivated anti-HIV antibody-rich plasma was compared with seronegative fresh-frozen seronegative plasma given in addition to zidovudine and other conventional prophylactic treatments. Seven transfusions every 2 weeks of immune plasma significantly reduced (2 vs. 8, P = .016) the number of opportunistic infections. Antigenemia became undetectable. When transfusions were stopped, positive p24 antigenemia returned at a level higher than before treatment and was correlated with a severe clinical deterioration, suggesting a rebound effect. This trial suggests that passive immunotherapy is promising in AIDS treatment. It confirms also that plasma donation does not affect donors' CD4 cell count over a 1-year period. In patients with severe immunodeficiency, special attention should be paid to withdrawal of an effective therapy as virologic relapse may be explosive and poorly tolerated.
Vittecoq
D
D
Unité de Traitement des Maladies Infectieuses et Dysimmunitaires and Hôpital Necker, Paris, France.
Mattlinger
B
B
Barre-Sinoussi
F
F
Courouce
A M
AM
Rouzioux
C
C
Doinel
C
C
Bary
M
M
Viard
J P
JP
Bach
J F
JF
Rouger
P
P
D000163:Acquired Immunodeficiency Syndrome / Q000628:therapy*; D001803:Blood Transfusion; D015153:Blotting, Western; D015483:HIV Antibodies / Q000627:therapeutic use*; D015488:HIV Antigens / Q000097:blood; D016655:HIV Core Protein p24 / Q000276:immunology; D006801:Humans; D007116:Immunization, Passive; D009894:Opportunistic Infections / Q000517:prevention & control; D010949:Plasma / Q000276:immunology
D015483:HIV Antibodies; D015488:HIV Antigens; D016655:HIV Core Protein p24