title: A study of the immunology, virology, and safety of prednisone in HIV-1-infected subjects with CD4 cell counts of 200 to 700 mm(-3).
abstract: Adult Clinical Trials Group Study 349 examined the immunology, virology, and safety of 40 mg/d prednisone as an adjunct to antiretroviral therapy in 24 HIV-infected subjects with >200 CD4+ T cells/mm in a randomized placebo-controlled trial. After 8 weeks, median lymphocyte and CD4+ cell numbers increased >40% above baseline values (p =.08). No effect was observed on markers of cell activation or apoptosis, although the proportion of CD28+ CD8+ T cells increased (p =.006). Prednisone inhibited monocyte TNFalpha production without affecting T-cell responses to antigens or mitogens. Two subjects assigned to prednisone were subsequently found to have asymptomatic osteonecrosis of the hip. Many questions remain regarding the role of activation-induced sequestration and apoptosis as causes of progressive CD4+ T-cell loss in AIDS. The potential role of corticosteroids as tools to examine this question will be limited by concerns regarding their toxicity; however, further studies of other agents to limit cellular activation in AIDS are warranted.
authors.affiliation: The University Medicine and Dentistry of New Jersey--New Jersey Medical School, Newark, USA. r.wallis@umdnj.edu
authors.forename: Robert S
authors.initials: RS
authors.lastname: Wallis
authors.forename: Robert
authors.initials: R
authors.lastname: Kalayjian
authors.forename: Jeffrey M
authors.initials: JM
authors.lastname: Jacobson
authors.forename: Lawrence
authors.initials: L
authors.lastname: Fox
authors.forename: Lynette
authors.initials: L
authors.lastname: Purdue
authors.forename: Cecilia M
authors.initials: CM
authors.lastname: Shikuma
authors.forename: Richard
authors.initials: R
authors.lastname: Arakaki
authors.forename: Stuart
authors.initials: S
authors.lastname: Snyder
authors.forename: Robert W
authors.initials: RW
authors.lastname: Coombs
authors.forename: Ronald J
authors.initials: RJ
authors.lastname: Bosch
authors.forename: John
authors.initials: J
authors.lastname: Spritzler
authors.forename: Miriam
authors.initials: M
authors.lastname: Chernoff
authors.forename: Evgenia
authors.initials: E
authors.lastname: Aga
authors.forename: Laurie
authors.initials: L
authors.lastname: Myers
authors.forename: Barbara
authors.initials: B
authors.lastname: Schock
authors.forename: Michael M
authors.initials: MM
authors.lastname: Lederman
mesh_terms: D000328:Adult; D019380:Anti-HIV Agents / Q000627:therapeutic use; D017209:Apoptosis; D018106:CD28 Antigens / Q000032:analysis; D018791:CD4 Lymphocyte Count; D016827:CD8 Antigens / Q000032:analysis; D004311:Double-Blind Method; D004359:Drug Therapy, Combination; D015658:HIV Infections / Q000188:drug therapy* / Q000276:immunology / Q000821:virology; D015497:HIV-1 / Q000235:genetics / Q000302:isolation & purification; D006615:Hip / Q000000981:diagnostic imaging; D006801:Humans; D018655:Lymphocyte Count; D010020:Osteonecrosis / Q000139:chemically induced / Q000000981:diagnostic imaging; D011239:Prednisolone / Q000009:adverse effects / Q000037:antagonists & inhibitors / Q000627:therapeutic use*; D012367:RNA, Viral / Q000097:blood; D011859:Radiography; D013601:T-Lymphocytes / Q000276:immunology / Q000473:pathology; D016896:Treatment Outcome; D014409:Tumor Necrosis Factor-alpha / Q000032:analysis / Q000096:biosynthesis
chemical_list: D019380:Anti-HIV Agents; D018106:CD28 Antigens; D016827:CD8 Antigens; D012367:RNA, Viral; D014409:Tumor Necrosis Factor-alpha; D011239:Prednisolone