Important note: Information in this article was accurate in September 2000. The state of the art may have changed since the publication date.
The reason that some PHAs develop certain cancers, but not others, is unclear. It may be that there are co-factors such as infection with other viruses, that are needed for these cancers to occur. Certainly infection with a herpes virus called EBV (Epstein-Barr virus) appears to play a role in the development of certain tumours. It may be that treatment with an anti-herpes drug can help shrink certain tumours. In TreatmentUpdate 100 we reported on the use of the anti-herpes drug ganciclovir combined with AZT and IL-2 (interleukin-2) for the treatment of lymphoma. In the report below we provide details concerning the successful use of another anti-herpes drug, foscarnet (Foscavir), for treatment of another AIDS-related tumour.
Doctors in Berlin reported results from their experiment on a 36-year old HIV+ male. When he first appeared at their clinic he had a CD4+ count of 50 cells and a viral load of 140,000 copies. As well he had the following symptoms for two months:
Various scans of his body suggested that a tumour had penetrated his bladder, rectum and intestines.
Surgeons attempted to repair some of the damage done by the tumour. In removing the tumour, they found pre-cancerous cells that were clearly going to spread to other areas of his body. Some of these cells were infected with EBV. Doctors then gave him intravenous foscarnet at a dose of 180 mg/kg of body weight for three weeks. During the second week he also started taking HAART.
According to the doctors, their patient "recovered rapidly" and regained control of his bowel and bladder. He also regained his weight and stayed well for at least 20 months and returned to work. At his last visit his viral load was undetectable and CD4+ count about 310 cells.
Since these results are unusual, especially when compared to those seen with cancer chemotherapy, the Berlin doctors consider anti-herpes virus therapy a "promising approach" for EBV stimulated B-cell tumours.
1. Schmidt W, Anagnostopoulos I and Scherubl H. Virostatic therapy for advanced lymphoproliferation associated with the Epstein-Barr Virus in an HIV-infected patient. N Engl J Med 2000 Feb 10;342(6):440-1.
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