TREATMENT OF IMMUNOLOGIC DISORDERS IN AIDS

Important note: Information in this article was accurate in 1986. The state of the art may have changed since the publication date.

TREATMENT OF IMMUNOLOGIC DISORDERS IN AIDS

AIDS. Etiology, Diagnosis, Treatment, and Prevention. DeVita VT, Hellman S, Rosenberg SA, eds. Philadelphia, J. B. Lippincott Company, p. 235-63, 1985.. Unique Identifier : AIDSLINE ICDB/86616581
Lotze MT; NCI, NIH, Bethesda, MD

Abstract: Treatment of immunologic disorders in acquired immunodeficiency syndrome (AIDS) is discussed under the following headings: immunologic defects and possible strategies, interferon trials (alpha interferon; gamma interferon), interleukin-2 trials, thymic hormones and factors, and other immunologic interventions (pharmacologic immunomodulators; adoptive immunotherapy). Many of the reported and ongoing clinical trials in the immunologic treatment of patients (pts) with AIDS were begun only within the last 2 yr and are not complete. As they become available, other biologic response modifiers and other therapeutic regimens will be tested for efficacy in AIDS. All of the immunotherapies currently employed to date have been ineffective; this conclusion must, however, remain tentative pending completion of the trials in progress. One of the difficulties in assessing the role of any therapeutic intervention is the lack of clearly defined in vitro parameters that correlate with the clinically desired outcomes of decreased or controlled opportunistic infections as well as eradication of such associated neoplasms as Kaposi's sarcoma (KS). All of the interferon trials to date, with both natural and recombinant alpha and gamma interferons, have demonstrated 30% to 40% response rates, with both partial and complete responses in KS. It appears that recombinant alpha and gamma interferon will be the standards against which other immunologic therapies must be compared. Interleukin-2 and thymic factors have so far shown no efficacy in pts with AIDS. Adoptive therapy either with bone marrow or with thymic transplants, which to date has been unsuccessful, appears to have the greatest likelihood of succeeding if the viral agent can be eradicated or controlled. (114 Refs)

Keywords: Acquired Immunodeficiency Syndrome/IMMUNOLOGY/*THERAPY Adjuvants, Immunologic/*THERAPEUTIC USE Antigen-Antibody Complex/IMMUNOLOGY Aziridines/THERAPEUTIC USE Blood Transfusion Bone Marrow/TRANSPLANTATION Bone Marrow Transplantation Clinical Trials Human Immunization, Passive Interferons/THERAPEUTIC USE Interleukin-2/THERAPEUTIC USE Isoprinosine/THERAPEUTIC USE Lymphocytes/TRANSPLANTATION T-Lymphocytes/IMMUNOLOGY Thymosin/THERAPEUTIC USE Thymus Hormones/THERAPEUTIC USE CLINICAL TRIAL MONOGRAPH REVIEW

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