title: Effects of tapering doses of oral prednisone on viral load among HIV-infected patients with unexplained weight loss.
abstract: In an exploratory study of virologic and immunomodulatory effects of corticosteroid therapy for wasting syndrome, four HIV-infected adults with recent unexplained weight loss were given tapering doses of prednisone over a 2-month period. Serum neopterin and TNF receptor II levels decreased from baseline after 7 days. An antiretroviral effect was observed initially, peaking on days 14-21 (mean change in HIV-1 branched chain DNA assay on day 21 of -0.52 log10; mean change, from baseline to nadir for each individual, of -0.63 log10); subsequent bDNA levels returned toward baseline as prednisone was tapered. No patient lost weight and there was a mean weight gain of 3.5 kg. Anecdotal reports of corticosteroid benefits in the wasting syndrome may result in part from decreased T cell activation leading to decreased HIV replication, an effect that may be self-limited or that may occur only at higher prednisone doses. Studies involving more targeted immunomodulatory agents for wasting syndrome are warranted.
authors.affiliation: Center for AIDS Research, Department of Pathology, University of Alabama at Birmingham School of Medicine, 35294, USA.
authors.forename: J M
authors.initials: JM
authors.lastname: Kilby
authors.forename: P B
authors.initials: PB
authors.lastname: Tabereaux
authors.forename: V
authors.initials: V
authors.lastname: Mulanovich
authors.forename: G M
authors.initials: GM
authors.lastname: Shaw
authors.forename: R P
authors.initials: RP
authors.lastname: Bucy
authors.forename: M S
authors.initials: MS
authors.lastname: Saag
mesh_terms: D000328:Adult; D018791:CD4 Lymphocyte Count; D004305:Dose-Response Relationship, Drug; D005260:Female; D019247:HIV Wasting Syndrome / Q000188:drug therapy* / Q000276:immunology; D006801:Humans; D008297:Male; D019798:Neopterin / Q000378:metabolism; D011241:Prednisone / Q000008:administration & dosage* / Q000009:adverse effects / Q000627:therapeutic use; D015431:Weight Loss
chemical_list: D019798:Neopterin; D011241:Prednisone