Induction and maintenance therapy with intermittent interleukin-2 in HIV-1 infection.
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.
Farel
Claire E
CE
Laboratory of Immunoregulation, National Institute of Allergy and Infectious Diseases, National Institutes of Health, Bethesda, MD 20892, USA.
Chaitt
Doreen G
DG
Hahn
Barbara K
BK
Tavel
Jorge A
JA
Kovacs
Joseph A
JA
Polis
Michael A
MA
Masur
Henry
H
Follmann
Dean A
DA
Lane
H Clifford
HC
Davey
Richard T
RT
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
D007376:Interleukin-2