Effects of long-term zidovudine treatment on cell-mediated immune response and lymphokine production

Article Abstract:

Long-term treatment with zidovudine (ZVD, also known as AZT) can lower the risk of developing opportunistic infections and reduce the death rate of patients with AIDS. (Opportunistic infections affect patients with impaired immune function; they often signal the development of AIDS and are a common cause of death.) However, long-term treatment with ZVD can also lead to the development of toxic side effects, including adverse effects on bone marrow cells that develop and mature to red and white blood cells, including lymphocytes, which are involved in the immune response. The effects of long-term treatment with ZVD on the growth and multiplication of immune cells and the production of lymphokines were analyzed in 15 patients with AIDS who had opportunistic infections. (Lymphokines are produced by lymphocytes and are important in immune reactions.) Lymphocytes were obtained from the patients prior to treatment with ZVD, and again after three and six months of treatment. The cells were treated with various agents, called mitogens, that induce growth and multiplication of lymphocytes; the production of lymphokines was then analyzed. The growth response of lymphocytes did not change significantly after treatment with mitogens. The production of the lymphokine interleukin-2 increased after treatment, while the production of two types of another lymphokine, gamma-interferon and alpha-interferon, decreased significantly. These findings suggest that treatment with ZVD did not cause adverse effects on the proliferation of lymphocytes, or on the production of interleukin-2, but did affect the production of gamma- and alpha-interferon. This could negatively affect the immune response of patients with AIDS. (Consumer Summary produced by Reliance Medical Information, Inc.)

Evaluation, Complications and side effects, Drug therapy, Zidovudine, Opportunistic infections, Cellular immunity

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Acute HIV-1 infection: clinical and biological study of 12 patients

Article Abstract:

While HIV infection is generally thought of as a silent infection, which shows its presence in the final development of AIDS after a long latency period, numerous cases of acute HIV infection have been reported in the medical literature. A prospective study has been able to monitor an acute phase of HIV infection in 12 patients. All patients developed fever, and all but one developed a general swelling of the lymph nodes (lymphadenopathy). Sore throat, rash, enlarged spleen, arthralgia and myalgia were seen in the majority of cases. These symptoms resolved after a period of 5 to 30 days; all patients were negative for HIV antibodies by enzyme immunoassay at the time of the acute infection, but the p24 antigen of HIV could be detected in 9 cases. After resolution of the acute infection, 10 patients continued to have persistent lymphadenopathy. There is reason to suspect that patients who develop acute illness soon after infection with HIV are likely to develop AIDS quickly. Six patients developed symptoms of AIDS-related complex an average of 17 months after the acute infection; two of these patients developed full-blown AIDS and one died 22 months after the initial infection. Histological examination of lymph nodes from these patients revealed a pattern of pathological changes which are different from those normally seen in patients with AIDS. The authors suggest that the observed changes, which include CD8+ cell infiltration of the follicles, represent an early stage of HIV infection, which precedes the more commonly seen follicular hyperplasia. (Consumer Summary produced by Reliance Medical Information, Inc.)

Case studies, Physiological aspects, HIV (Viruses), HIV

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Risk of developing AIDS after primary acute HIV-1 infection

Article Abstract:

People who developed symptoms of HIV infection after becoming HIV-1 positive were likely to develop AIDS more quickly than those who became HIV-positive without any symptoms. Researchers followed the development of AIDS in 134 patients who became HIV-positive, but had a negative HIV test within the previous 12 months. Twenty-three developed symptoms of HIV infection shortly after becoming HIV-positive. They had a higher risk of developing AIDS within 56 months after testing positive than those who had no symptoms. Patients who were infected through sexual transmission had a higher risk of developing AIDS sooner than the patients who were infected through intravenous drug use. This is in agreement with other studies which found a higher rate of acute conversion to HIV-positive status in cases of sexual or blood-related transmissions.

Development and progression

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