Corticosteroids and HIV infection: a review of experience.
OBJECTIVE
Apoptosis caused by immune activation is thought to be an important mechanism for progressive CD4 T-cell depletion in HIV disease. This review examines published literature on the effects of corticosteroids on activation markers and disease indicators in HIV.


RESULTS
Salutary effects were noted on activation markers, apoptosis and circulating CD4 T-cell numbers in studies in which corticosteroids were administered together with antiretroviral therapy. Safety concerns regarding osteonecrosis of the hip have limited further research in this area. Controlled trials in which corticosteroids were administered in the absence of antiretroviral therapy have generally not shown a clinical benefit to this treatment.


CONCLUSIONS
These studies may indicate a potential role for deactivating strategies in the management of HIV infection. Targeted therapies with superior long-term safety profiles will be required for this concept to advance further in clinical trials.
PPD, Washington, District of Columbia, USA.
Robert S
RS
Wallis