AIDS TREATMENT NEWS Issue #209, October 21, 1994
John S. James
Passive hyperimmune therapy uses plasma from blood donors who have HIV but are healthy, and are apparently controlling the virus well. This plasma is sterilized to avoid transmitting any new virus, then is infused into persons with AIDS. The plasma contains antibodies, and perhaps other substances, which may be helpful to recipients who have lost the ability to produce them. This approach to treatment has been used successfully in a number of other diseases. (Note: All available information indicates that donation of plasma is not harmful to persons with HIV; some data suggests that the donations may be helpful.)
The study published in BLOOD was sponsored by the HemaCare Corporation in Los Angeles, California. It included 220 patients, and randomly assigned them to three treatment groups: full dose treatment (500 ml of plasma once a month), half dose treatment, and placebo.
Benefits were found only in the recipients with baseline T- helper counts between 50 and 200. (It is not known if those with higher T-helper counts could benefit, as there were only 24 such volunteers among the 220 in this study -- too few to show an effect.) There was one death among 21 people in the full-dose group, vs. three among 21 with half dose, and six among 30 on the placebo; this did not quite reach the conventional criterion for statistical significance (p = .065 in the study). T-helper count changes were statistically significant: full dose improvement was 32.7 cells, half-dose was 0.9, and the placebo group lost an average of 3.5 in T- helper count.
There were no significant differences between the groups in opportunistic infections, however. This is different from the results of the French study, which found three times as many AIDS-related illnesses in the placebo group, according to a report in the INDEPENDENT (London), October 2.
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