title: Induction and maintenance therapy with intermittent interleukin-2 in HIV-1 infection.
abstract: Studies establishing that intermittent subcutaneous interleukin-2 (IL-2) therapy can lead to substantial CD4 cell increases in many HIV-infected patients have generally been of limited duration. We studied 77 patients participating in active longitudinal studies of subcutaneous IL-2 therapy at our center in order to determine the long-term feasibility of this approach. Following initial induction, patients in each trial were eligible to receive intermittent 5-day cycles of subcutaneous IL-2 treatment at individualized doses and frequencies capable of maintaining CD4 counts at postinduction levels. The mean duration of study participation to date is 5.9 years (range, 1.0-9.3 years). Mean baseline CD4 cell count and CD4 percent values of 0.521 x 10(9)/L (521 cells/microL) and 27% have risen to 1.005 x 10(9)/L (1005 cells/microL) and 38%, respectively, at 90 months. The mean number of subcutaneous IL-2 cycles required to achieve and maintain these increases was 10 cycles (range, 3-29 cycles), and the current mean interval of cycling required to maintain these elevations is 39 months (median, 35 months; range, 2-91 months). We conclude that subcutaneous IL-2 therapy is capable of maintaining CD4 cell increases for an extended period using a remarkably low frequency of intermittent cycling. These observations may contribute to patients' acceptance of subcutaneous IL-2 as a favorable long-term treatment strategy.
authors.affiliation: Laboratory of Immunoregulation, National Institute of Allergy and Infectious Diseases, National Institutes of Health, Bethesda, MD 20892, USA.
authors.forename: Claire E
authors.initials: CE
authors.lastname: Farel
authors.forename: Doreen G
authors.initials: DG
authors.lastname: Chaitt
authors.forename: Barbara K
authors.initials: BK
authors.lastname: Hahn
authors.forename: Jorge A
authors.initials: JA
authors.lastname: Tavel
authors.forename: Joseph A
authors.initials: JA
authors.lastname: Kovacs
authors.forename: Michael A
authors.initials: MA
authors.lastname: Polis
authors.forename: Henry
authors.initials: H
authors.lastname: Masur
authors.forename: Dean A
authors.initials: DA
authors.lastname: Follmann
authors.forename: H Clifford
authors.initials: HC
authors.lastname: Lane
authors.forename: Richard T
authors.initials: RT
authors.lastname: Davey
mesh_terms: D000328:Adult; D018791:CD4 Lymphocyte Count; D004334:Drug Administration Schedule; D005240:Feasibility Studies; D005260:Female; D015658:HIV Infections / Q000188:drug therapy*; D015497:HIV-1; D006801:Humans; D007279:Injections, Subcutaneous; D007376:Interleukin-2 / Q000008:administration & dosage* / Q000627:therapeutic use; D008137:Longitudinal Studies; D008297:Male; D010349:Patient Compliance; D012074:Remission Induction / Q000379:methods
chemical_list: D007376:Interleukin-2