title: The effects of high-dose recombinant soluble CD4 on human immunodeficiency virus type 1 viremia.
abstract: In vitro, low-passage clinical human immunodeficiency virus type 1 (HIV-1) isolates require up to 1000 times greater serum levels of recombinant soluble CD4 (rsCD4) than have ever been given. To determine if sufficient serum levels of rsCD4 provide in vivo inhibition of HIV-1, 4 HIV-1 plasma-viremic subjects were given single-dose boluses of 2, 4, 6, 8, and 10 mg/kg intravenous rsCD4. Plasma HIV-1 cultures were done after infusion. Three subjects demonstrated a dose-dependent reduction in plasma HIV-1 viremia. The inhibitory effect of rsCD4 on plasma HIV-1 viremia was associated with the in vitro ID90-95 of the isolate, not the ID50. These data demonstrate that extremely high doses of rsCD4 inactivate cell-free HIV-1 in vivo and suggest that high doses of rsCD4 may have some short-term therapeutic utility, such as with accidental or occupational HIV-1 exposure.
authors.affiliation: Department of Medicine, University of Washington School of Medicine, Seattle.
authors.forename: T
authors.initials: T
authors.lastname: Schacker
authors.forename: R W
authors.initials: RW
authors.lastname: Coombs
authors.forename: A C
authors.initials: AC
authors.lastname: Collier
authors.forename: J E
authors.initials: JE
authors.lastname: Zeh
authors.forename: I
authors.initials: I
authors.lastname: Fox
authors.forename: J
authors.initials: J
authors.lastname: Alam
authors.forename: K
authors.initials: K
authors.lastname: Nelson
authors.forename: E
authors.initials: E
authors.lastname: Eggert
authors.forename: L
authors.initials: L
authors.lastname: Corey
mesh_terms: D015704:CD4 Antigens / Q000008:administration & dosage / Q000097:blood / Q000494:pharmacology* / Q000627:therapeutic use; D004305:Dose-Response Relationship, Drug; D005260:Female; D015658:HIV Infections / Q000188:drug therapy*; D015497:HIV-1 / Q000187:drug effects*; D006801:Humans; D007262:Infusions, Intravenous; D008297:Male; D010865:Pilot Projects; D011994:Recombinant Proteins / Q000008:administration & dosage / Q000097:blood / Q000494:pharmacology / Q000627:therapeutic use; D012044:Regression Analysis; D014766:Viremia / Q000188:drug therapy*
chemical_list: D015704:CD4 Antigens; D011994:Recombinant Proteins