A phase I/II trial of zidovudine, interferon-alpha, and granulocyte-macrophage colony-stimulating factor in the treatment of human immunodeficiency virus type I infection

Article Abstract:

Drugs used to treat bacterial infection of the blood and certain types of blood and solid tissue cancers are now being considered for treatment of infection with human immunodeficiency virus type I (HIV-I), which causes AIDS. The combined use of agents with different mechanisms of action, side effects, or patterns of resistance may be effective in eliminating HIV-I infection. If the antiviral actions of drugs are synergistic, or greater when combined than when used alone, it may be possible to administer lower doses of each drug. In addition, optimal doses of drugs with similar mechanisms of actions, but different toxic effects can be used in combined regimens. Viral resistance to a drug may develop less readily with combined regimens than with single drug therapy. The antiviral agent zidovudine interferes with the production of genetic material of HIV-I, whereas interferon-alpha (IFN-alpha) prevents the production of the virus. Zidovudine and IFN-alpha were reported to be synergistic, but cause neutropenia, a severe decrease in the number of neutrophils (a type of white blood cell). Recombinant human granulocyte-macrophage colony-stimulating factor (GM-CSF) is a growth factor that can be produced artificially in large amounts using recombinant technology. GM-CSF was shown to improve neutropenia in patients with cancer, AIDS, or bone marrow suppression. The side effects of GM-CSF are mild, related to dosage, and include fever and bone pain. The effectiveness of GM-CSF in treating neutropenia associated with combined zidovudine and IFN-alpha treatment was assessed in 24 HIV-I-infected patients. The blood levels of p24 antigen, a measure of HIV-I infection, decreased by more than 70 percent in five patients with this antigen. Combined treatment with zidovudine, IFN-alpha, and GM-CSF was associated with lymphokine-like side effects: loss of appetite, weight loss, fatigue, and a decrease in red blood cells. However, GM-CSF improved neutropenia without reducing the antiviral action of zidovudine and IFN-alpha. (Consumer Summary produced by Reliance Medical Information, Inc.)

Health aspects, Causes of, Interferon alpha, Neutropenia, Granulocyte-macrophage colony stimulating factor

---

Zidovudine in patients with human immunodeficiency virus (HIV) infection and Kaposi sarcoma: a phase II randomized, placebo-controlled trial

Article Abstract:

Zidovudine, also known as AZT, has been shown to significantly prolong survival and decrease the frequency of opportunistic infections in patients with advanced infections of HIV (human immunodeficiency virus), which causes AIDS (acquired immunodeficiency syndrome). Zidovudine has not been shown to have any effect in patients with earlier stages of HIV infection, whose immune systems are not as compromised as those in later stages of disease. Thirty-seven patients who had early infections with HIV and Kaposi's sarcoma were treated with zidovudine. (Kaposi's sarcoma is a form of cancer that has been associated with AIDS.) The toxicity, effects on various immune functions, activity against the tumor and the virus, and the pharmacokinetics of zidovudine were examined. Treatment with zidovudine was well tolerated in patients, with the major side effects being anemia and granulocytopenia, or low numbers of granulocytic white blood cells. Significant increases in the number of platelets, cells involved in blood clotting, and declines in the levels of viral antigens were seen after treatment. After treatment with zidovudine, patients were less likely to have HIV in their cerebrospinal fluid. However, treatment of patients with early HIV infection and Kaposi's sarcoma with zidovudine did not stop the progression of the sarcoma. Treatment did not increase the numbers of CD4+ or CD8+ cells, which are involved in immune responses and are decreased in patients with AIDS, nor did it increase other immune functions. (Consumer Summary produced by Reliance Medical Information, Inc.)

AIDS (Disease), Kaposi's sarcoma

---

Syngeneic bone marrow transplantation and adoptive transfer of peripheral blood lymphocytes combined with zidovudine in human immunodeficiency virus (HIV) infection

Article Abstract:

The effects of bone marrow transplantation between compatible individuals (syngeneic), along with the administration of lymphocytes (a type of immune cell) and the drug zidovudine, were assessed in 16 patients infected with human immunodeficiency virus (HIV). A dose of 500 milligrams (mg) of zidovudine was given orally every four hours to HIV-infected patients for 12 weeks; this was combined with six infusions of lymphocytes at week 10 and week 12. The patients underwent bone marrow transplantation during week 12. The number of CD4 cells, a type of immune cell, increased after infusion of lymphocytes and bone marrow transplantation. However, the number of patients developing hypersensitivity reactions after immunization with tetanus toxoid increased. In addition, 8 out of 12 patients developed hypersensitivity to hemocyanin, given to stimulate antibody production. This therapeutic regimen did produce sustained clinical or immune improvement in HIV-infected patients. Patients who received zidovudine and patients who were not treated after transplantation did not differ in the number of CD4 cells, hypersensitivity reactions, HIV cultures, or levels of p24 antigens (a portion of the virus), in the blood. These findings suggest that the combined regimen of syngeneic bone marrow transplantation, lymphocyte infusion, and zidovudine treatment produces only transient beneficial results in HIV-infected patients. (Consumer Summary produced by Reliance Medical Information, Inc.)

Care and treatment, Bone marrow, Bone marrow transplantation, Lymphocytes

Similar abstracts:

• Abstracts: Allogeneic bone marrow transplantation, zidovudine, and human immunodeficiency virus type 1 (HIV-1) infection
• Abstracts: Natural history and serologic diagnosis of infants born to human immunodeficiency virus-infected women. The human immunodeficiency virus-infected infant
• Abstracts: Seroepidemiologic studies of cytomegalovirus and Epstein-Barr virus infections in relation to human immunodeficiency virus type 1 infection in selected recipient populations
• Abstracts: Small intestinal structure and function in patients infected with human immunodeficiency virus (HIV): evidence for HIV-induced enteropathy

This website is not affiliated with document authors or copyright owners. This page is provided for informational purposes only. Unintentional errors are possible.