Beta-interferon therapy in patients with poor-prognosis Kaposi sarcoma related to the acquired immunodeficiency syndrome (AIDS)

Article Abstract:

Interferons are factors produced by cells of the immune system that are involved in the stimulation and development of an immune response. A 20 to 40 percent response rate has been reported with alpha-interferon therapy in patients with Kaposi's sarcoma, a malignant disease that is related to early-stage acquired immunodeficiency syndrome (AIDS). Patients with Kaposi's sarcoma who were treated with alpha-interferon had lower levels of infection, and some activity against human immunodeficiency virus (HIV, which causes AIDS) has been shown. However, alpha-interferon can only be given at certain doses because the drug can be toxic to blood cells and cause liver complications. Blood cell toxicity has also been noted with the drug zidovudine, which is used to treat AIDS. When alpha-interferon and zidovudine are used together in a combined therapy, the maximum dose that can be used to prevent toxicity is one half of the dose of each drug when it is used alone. However, beta-interferon, which has many of the same immunological effects as alpha-interferon, including antiviral activity, can be used at higher doses before toxicity develops. The efficacy of high doses of beta-interferon was examined in 38 patients with AIDS-related Kaposi's sarcoma. The majority of the patients, however, were in the later stages of AIDS and had clinical or laboratory conditions which predicted a poor response to interferon treatment. AIDS and Kaposi's sarcoma remained stable in 40 percent of the patients for more than 26 weeks. However, only 16 percent of the patients showed a favorable response to the beta-interferon treatment. Some antiviral activity was seen with the use of beta-interferon, and there was a decrease in the number of infections that would be expected in a similar group of patients. Minimal toxicity was primarily localized to the skin. Therefore, the response of patients with Kaposi's sarcoma to beta-interferon, as with alpha-interferon, is minimal at advanced stages of AIDS. (Consumer Summary produced by Reliance Medical Information, Inc.)

Health aspects, Case studies, Dosage and administration, Interferon, Immunotherapy

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Interferon-alpha with zidovudine: safety, tolerance, and clinical and virologic effects in patients with Kaposi sarcoma associated with acquired immunodeficiency syndrome (AIDS)

Article Abstract:

The effectiveness, safety, and patient tolerance of interferon-alpha and zidovudine in combination were assessed among 43 patients with Kaposi sarcoma and acquired immunodeficiency syndrome (AIDS). Kaposi sarcoma consists of malignant lesions affecting the skin and other body sites, most likely resulting from the decreased immune function of the patient. In this study, the toxic effects of the combined interferon-alpha and zidovudine regimen included: neutropenia, a decrease in neutrophils, a type of white blood cell; fatigue; elevated liver enzyme levels; anemia; and thrombocytopenia, a reduction in platelets, which are blood cells involved in clotting. The development of these toxic effects was related to the dose of the drugs. The largest doses of the medications that could be tolerated were determined. Among 37 patients who could be evaluated, 17 showed complete or partial regression of the Kaposi tumor. The levels of CD4 cells, a type of immune cell that is particularly vulnerable to the AIDS virus, serve as an indicator of disease activity. The medications were more effective among patients with baseline (before treatment) CD4 counts above 200 million cells per liter than patients with lower counts. The effects of the antiviral agents on CD4 cells were related to the initial CD4 count and the dose of interferon. The combined drug regimen decreased the levels of p24 antigen, the portion of the AIDS virus that causes an immune response, and the amounts of virus isolated from the blood. The results show that interferon-alpha combined with zidovudine can be safely used to treat patients with Kaposi sarcoma and AIDS. The effects of the drug combination on Kaposi tumor growth, replication of HIV, and immune function indicate that further investigation of this regimen is warranted; patients at various stages of HIV infection should be studied. (Consumer Summary produced by Reliance Medical Information, Inc.)

Evaluation, Complications and side effects, Zidovudine

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Relationship and prognostic value of endogenous interferon-alpha, beta-two-microglobulin, and neopterin serum levels in patients with Kaposi sarcoma and AIDS

Article Abstract:

The production of beta-two-microglobulin and neopterin is stimulated by interferon-alpha, a substance that is produced by activated immune cells. The level of production of the beta-two-microglobulin and neopterin molecules correlates with the stage of disease in patients who are infected with the human immunodeficiency virus (HIV), which is associated with AIDS. Hence, they can be used as markers to evaluate the stage of HIV infection. The number of CD4+ helper T lymphocytes, a type of white blood cell, decreases as HIV infection progresses and is also used as a disease marker. This study assessed HIV-infected patients who had AIDS-related Kaposi's sarcoma to see if the levels of beta-two-microglobulin and neopterin correlate with the disease prognosis, including tumor regression and survival. (Kaposi's sarcoma is a cancer that commonly occurs in patients with AIDS.) The levels of the two molecules were higher in patients who had high levels of interferon-alpha, and were correlated with a poor prognosis. The use of these two markers, along with the number of CD4+ cells, may be valuable in assessing prognosis, and selecting and evaluating treatment for patients with Kaposi's sarcoma and AIDS. (Consumer Summary produced by Reliance Medical Information, Inc.)

Measurement, Physiological aspects, Development and progression, Prognosis, HIV infection, HIV infections, Beta globulins

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