title: Cyclosporin A provides no sustained immunologic benefit to persons with chronic HIV-1 infection starting suppressive antiretroviral therapy: results of a randomized, controlled trial of the AIDS Clinical Trials Group A5138.
abstract: BACKGROUND
  Although the determinants of immune deficiency and immune restoration in chronic human immunodeficiency virus (HIV)-1 infection are not well understood, immune activation has been proposed as being central to the pathogenesis of HIV.
  
  
  METHODS
  A randomized, controlled trial of cyclosporin A treatment for 2 weeks was performed in persons with chronic HIV-1 infection who were beginning a standardized antiretroviral therapy (ART) regimen.
  
  
  RESULTS
  Treatment with cyclosporin A provided only a marginal and transient enhancement in circulating T cell restoration that was largely restricted to cells expressing the CCR7 chemokine receptor and that did not persist beyond 2 weeks.
  
  
  CONCLUSIONS
  Cyclosporin A coadministered for 2 weeks with ART provided no sustained immunologic benefit to persons with chronic HIV-1 infection. If immune activation drives progressive immune deficiency in chronic HIV-1 infection, these activation pathways may not be sensitive to cyclosporin.
authors.affiliation: Case Western Reserve University, University Hospitals of Cleveland, Cleveland, OH 44106, USA. MXL6@case.edu
authors.forename: Michael M
authors.initials: MM
authors.lastname: Lederman
authors.forename: Laura
authors.initials: L
authors.lastname: Smeaton
authors.forename: Kim Y
authors.initials: KY
authors.lastname: Smith
authors.forename: Benigno
authors.initials: B
authors.lastname: Rodriguez
authors.forename: Minya
authors.initials: M
authors.lastname: Pu
authors.forename: Hongying
authors.initials: H
authors.lastname: Wang
authors.forename: Anne
authors.initials: A
authors.lastname: Sevin
authors.forename: Pablo
authors.initials: P
authors.lastname: Tebas
authors.forename: Scott F
authors.initials: SF
authors.lastname: Sieg
authors.forename: Kathy
authors.initials: K
authors.lastname: Medvik
authors.forename: David M
authors.initials: DM
authors.lastname: Margolis
authors.forename: Richard
authors.initials: R
authors.lastname: Pollard
authors.forename: Hildegund C J
authors.initials: HC
authors.lastname: Ertl
authors.forename: Hernan
authors.initials: H
authors.lastname: Valdez
mesh_terms: D000328:Adult; D044966:Anti-Retroviral Agents / Q000627:therapeutic use*; D002908:Chronic Disease; D016572:Cyclosporine / Q000008:administration & dosage / Q000627:therapeutic use*; D004334:Drug Administration Schedule; D004359:Drug Therapy, Combination; D005260:Female; D015658:HIV Infections / Q000188:drug therapy* / Q000276:immunology; D015497:HIV-1; D006801:Humans; D007166:Immunosuppressive Agents / Q000008:administration & dosage / Q000627:therapeutic use*; D018655:Lymphocyte Count; D008297:Male; D008875:Middle Aged; D019707:Receptors, Chemokine / Q000096:biosynthesis; D013601:T-Lymphocytes / Q000276:immunology; D016896:Treatment Outcome
chemical_list: D044966:Anti-Retroviral Agents; D007166:Immunosuppressive Agents; D019707:Receptors, Chemokine; D016572:Cyclosporine