Polymerase chain reaction evidence for human immunodeficiency virus 1 neutralization by passive immunization in patients with AIDS and AIDS-related complex.
We tried to assess the long-term safety and potential efficacy of passive immunization in AIDS-related-complex (ARC) and AIDS patients. We also wanted to establish whether hyperimmune plasma from healthy human immunodeficiency virus 1 (HIV-1)-infected individuals clears the cell-free virus from circulation. Using the polymerase chain reaction (PCR), we were able to provide conclusive evidence that hyperimmune plasma is effective and maintains long-term neutralization of viremia. Using the cell test, we found that in most patients the total antibody level was maintained; in one of the ARC patients, it actually increased 8-fold and has remained at that level for nearly 2 years. The CD4+ cell count decreased in the AIDS patients but was stable in the ARC patient. Clinically, there was an initial improvement in all patients, but five of six of the advanced/terminal AIDS patients had died by month 17. Our studies suggest that passive immunization may be safe in ARC and AIDS patients. It reduces HIV-1 viremia to levels undetectable even by PCR. To advanced/terminal patients, the benefit is of limited duration, while to ARC patients it may be long-term. Therefore, passive immunization should start early in the disease.
Karpas
A
A
Department of Haematology, Cambridge University Clinical School, United Kingdom.
Hewlett
I K
IK
Hill
F
F
Gray
J
J
Byron
N
N
Gilgen
D
D
Bally
V
V
Oates
J K
JK
Gazzard
B
B
Epstein
J E
JE
D000386:AIDS-Related Complex / Q000276:immunology* / Q000382:microbiology; D000163:Acquired Immunodeficiency Syndrome / Q000276:immunology* / Q000382:microbiology; D015704:CD4 Antigens / Q000032:analysis; D004279:DNA, Viral / Q000097:blood / Q000302:isolation & purification; D015483:HIV Antibodies / Q000032:analysis*; D015488:HIV Antigens / Q000032:analysis; D015497:HIV-1 / Q000235:genetics / Q000276:immunology* / Q000302:isolation & purification; D006801:Humans; D007116:Immunization, Passive; D016133:Polymerase Chain Reaction / Q000379:methods*; D012367:RNA, Viral / Q000097:blood / Q000302:isolation & purification; D006377:T-Lymphocytes, Helper-Inducer / Q000276:immunology
D015704:CD4 Antigens; D004279:DNA, Viral; D015483:HIV Antibodies; D015488:HIV Antigens; D012367:RNA, Viral