AIDSWEEKLY Plus; November 4, 2002
Michael Greer, Senior Medical Writer

"Haematological abnormalities frequently occur in patients infected by human immunodeficiency virus-type 1 (HIV-1)," according to Antonella Isgro and colleagues at the University of Rome "La Sapienza" and the San Raffaele Telethon Institute for Gene Therapy in Milan. "Increasing evidence indicates that bone marrow suppression (BM) results from viral infection of accessory cells, with impaired stromal function and alteration of haematopoietic growth factor network."

Highly active antiretroviral therapy (HAART) restores a healthy stromal environment and normalizes hematopoietic cytokine activity, Isgro and coauthors found.

The researchers compared hematopoietic activity in bone marrow (BM) from HIV patients before and after the initiation of HAART. Prior to treatment, bone marrow cells produced lower levels of interleukin (IL)-2 and higher levels of inflammatory cytokines like tumor necrosis factor alpha, macrophage inflammatory protein, and RANTES, they said.

After beginning HAART, cytokine production by bone marrow cells returned to normal levels, study data showed. In addition, while stromal cells showed macrophage-like features and expressed HIV DNA before HAART, antiretroviral treatment restored normal fibroblast-like morphology to these cells and blocked viral DNA expression.

HAART was also associated with the recovery of stem cell clonogenic capability lost after HIV infection (Improvement of interleukin 2 production, clonogenic capability and restoration of stromal cell function in human immunodeficiency virus-type-1 patients after highly active antiretroviral therapy. Br J Haematol 2002 Sep;118(3):864-74.

"Controlling HIV-1 replication may produce amelioration of stem cell activity, and restoration of stromal cell pattern and functions, with increased IL-2 production at BM level," Isgro and colleagues concluded.

The corresponding author for this report is Prof. Fernando Aiuti, Division of Allergy and Clinical Immunology Department of Clinical Medicine, University of Rome "La Sapienza", Viale dell'Universita, 37-00185 Rome, Italy. E-mail: fernando.aiuti@uniroma1.it.

A search at www.NewsRx.net using the search term "AIDS and HIV therapy" yielded 1193 articles in 29 specialized reports.

Key points reported in this study include:

• Highly active antiretroviral therapy (HAART) against HIV infection can restore normal hematopoietic stem cell activity

• HAART normalized bone marrow cytokine production and stromal cell function altered after HIV infection

• HAART was also associated with recovery of impaired stem cell clonogenic capability

This article was prepared by AIDS Weekly editors from staff and other reports.

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