Sustained suppression of HCV replication and inflammatory activity after interleukin-2 therapy in patients with HIV/hepatitis C virus coinfection.
OBJECTIVE
There is increasing evidence that coinfection of hepatitis C (HCV) with HIV is associated with accelerated progression of liver cirrhosis. The aim of this pilot study was to investigate toxicity and efficacy of interleukin-2 (IL-2) for treatment of affected patients.


METHODS
Because low-dose, daily IL-2 therapy is well tolerated and can elevate CD4 cell counts and improve immune functions, patients were treated with 1-2 million units (MU) IL-2 subcutaneously daily.


METHODS
This pilot trial included 7 HIV/HCV-coinfected individuals. During therapy, clinical, virologic, and laboratory parameters were closely monitored.


RESULTS
All patients responded to IL-2 therapy with either improvement of either CD4 cell counts or liver function test results. In 2 patients, HCV-RNA in serum became negative 2 and 4 months, respectively, after cessation of therapy. HCV-RNA has remained undetectable in these 2 patients for 18 and 24 months, respectively. Therapy was well tolerated and no grade III or IV toxicities were observed.


CONCLUSIONS
Low-dose, daily IL-2 therapy can improve both CD4 cell counts and liver function test results in patients with HIV/HCV coinfection and may in some cases lead to sustained suppression of viremia of HCV.
Schlaak
Jörg F
JF
Department of Medicine A, Imperial College, School of Medicine, St. Mary's Hospital, London, UK. j.schlaak@ic.ac.uk
Schramm
C
C
Radecke
K
K
zum Büschenfelde
K-H Meyer
KH
Gerken
G
G
D000328:Adult; D000410:Alanine Transaminase / Q000097:blood; D018791:CD4 Lymphocyte Count; D005260:Female; D015658:HIV Infections / Q000150:complications / Q000188:drug therapy* / Q000276:immunology / Q000821:virology; D016174:Hepacivirus / Q000187:drug effects* / Q000235:genetics / Q000276:immunology / Q000502:physiology; D006526:Hepatitis C / Q000150:complications / Q000188:drug therapy / Q000276:immunology / Q000821:virology*; D006801:Humans; D007376:Interleukin-2 / Q000008:administration & dosage / Q000627:therapeutic use*; D008297:Male; D008875:Middle Aged; D010865:Pilot Projects; D012367:RNA, Viral / Q000097:blood / Q000187:drug effects; D016896:Treatment Outcome; D014766:Viremia; D014779:Virus Replication / Q000187:drug effects*
D007376:Interleukin-2; D012367:RNA, Viral; D000410:Alanine Transaminase