Extracorporeal photopheresis in the treatment of AIDS-related complex: a pilot study.
OBJECTIVE
To determine side effects of extracorporeal photopheresis in the treatment of patients with the acquired immunodeficiency syndrome (AIDS)-related complex, and to gain early evidence of efficacy of the treatment.


METHODS
Uncontrolled trial.


METHODS
Tertiary referral center.


METHODS
Five patients with AIDS-related complex: three homosexual men and one man and one woman with histories of intravenous drug abuse. One patient, a homosexual man, withdrew from therapy after 5 months but returned for monthly clinical and laboratory evaluations.


METHODS
Monthly treatments with extracorporeal photopheresis.


RESULTS
Symptoms resolved in four patients. Lymphadenopathy disappeared in all five. Four patients had delayed-hypersensitivity reactions to skin testing (as defined by the Walter Reed staging classification). All showed increases in p24 and gp120 antibody levels. The CD4-cell percentage increased in four patients and declined in one after 6 months of therapy, but the absolute CD4 count decreased in two patients. At 15 months, the CD4 percentage remained at or increased over the baseline value in three patients still in the study but decreased in one. Levels of Beta 2-microglobulin decreased or remained stable in four patients. All patients were culture positive for the human immunodeficiency virus (HIV) before treatment. One patient had a negative viral culture after 5 months of treatment with confirmation. Two other patients became HIV culture negative, one at 14 and one at 15 months: The former patient became positive at 15 months and the latter patient remained negative at 16 months.


CONCLUSIONS
The preliminary results suggest that extracorporeal photopheresis deserves further evaluation as therapy for AIDS-related complex.
Bisaccia
E
E
Morristown Memorial Hospital, New Jersey.
Berger
C
C
Klainer
A S
AS
D000386:AIDS-Related Complex / Q000188:drug therapy* / Q000276:immunology / Q000473:pathology; D000328:Adult; D015496:CD4-Positive T-Lymphocytes / Q000276:immunology; D005260:Female; D006801:Humans; D006968:Hypersensitivity, Delayed / Q000175:diagnosis; D007958:Leukocyte Count; D008198:Lymph Nodes / Q000473:pathology; D008297:Male; D011701:PUVA Therapy / Q000009:adverse effects / Q000379:methods*; D010865:Pilot Projects; D012882:Skin Tests; D050378:T-Lymphocytes, Regulatory / Q000276:immunology