Effects of tapering doses of oral prednisone on viral load among HIV-infected patients with unexplained weight loss.
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.
Kilby
J M
JM
Center for AIDS Research, Department of Pathology, University of Alabama at Birmingham School of Medicine, 35294, USA.
Tabereaux
P B
PB
Mulanovich
V
V
Shaw
G M
GM
Bucy
R P
RP
Saag
M S
MS
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
D019798:Neopterin; D011241:Prednisone