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Báo cáo y học: " Continuing or adding IL-2 in patients treated with antiretroviral therapy (ACTG Protocol A5051, a rollover trial of ACTG Protocol A3"

Tuyển tập các báo cáo nghiên cứu về y học được đăng trên tạp chí y học Wertheim cung cấp cho các bạn kiến thức về ngành y đề tài: Continuing or adding IL-2 in patients treated with antiretroviral therapy (ACTG Protocol A5051, a rollover trial of ACTG Protocol A328. | Bosch et al. AIDS Research and Therapy 2010 7 30 http www.aidsrestherapy.eom content 7 1 30 AIDS RESEARCH AND THERAPY RESEARCH Open Access Continuing or adding IL-2 in patients treated with antiretroviral therapy ACTG Protocol A5051 a rollover trial of ACTG Protocol A328 D I 1 I D D D I I 2 A I I 3 r I . x- A . 1 I c Z X 4 D I I I r I h 1 r I5 Ronald J Bosch Richard B Pollard Alan Landay Evgenia Aga Lawrence Fox Ronald Mitsuyasu Abstract Background Effective antiretroviral therapy reduces HIV-1 RNA levels improves CD4 T-cell counts and lowers the risk of opportunistic infections and malignancies. Interleukin-2 IL-2 has been shown to increase CD4 T-cell numbers mainly by expanding CD4 cells and by prolonging their half-lives. HIV-infected patients previously enrolled into A328 had been randomized to antiretroviral therapy ART alone or ART followed by IL-2. In A5051 53 patients from A328 who had previously received IL-2 were allowed to continue IL-2 for an additional 80 weeks 27 patients who had received ART alone received IL-2 for 80 weeks. Results The patients previously receiving IL-2 continued to have elevated CD4 levels with extended use of IL-2. The prior ART-alone recipients had increases in CD4 levels to comparable levels as the prior IL-2 recipients median 804 versus 847 cells mm3 at week 72 60 versus 9 had 50 increase in A5051 to week 72 p 0.001 . Those who had previously received IL-2 required fewer IL-2 cycles to maintain their CD4 T-cell counts compared to those newly initiating IL-2. The treatments were well tolerated with no significant differences in toxicity or discontinuations between those newly versus previously receiving IL-2. There were few clinical events observed. Conclusions Although sustained CD4 T-cell count increases were seen with IL-2 administration as in other studies the absence of clinical benefit in two recent randomized trials has demonstrated no apparent role for IL-2 as a therapy in HIV disease. Trial Registration A5051 .