Prophylaxis against opportunistic infections in patients with human immunodeficiency virus infection

Article Abstract:

Preventing opportunistic infections can prolong the lives of HIV patients. HIV weakens the immune system, causing patients to develop infections that healthy people don't get. Some diseases, such as tuberculosis, can be prevented simply by avoiding contact with people who have the disease. HIV patients can also be vaccinated against some diseases, such as pneumococcal infection. Some antibiotics can be given prophylactically, in other words, before the patient has actually developed the infection. Patients who are taking highly active antiretroviral therapy (HAART) may be able to stop prophylactic therapy altogether because HAART strengthens the immune system.

Prevention, Opportunistic infections

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Reversible cardiac dysfunction associated with interferon alfa therapy in AIDS patients with Kaposi's sarcoma

Article Abstract:

Interferons are a family of proteins normally made in the body by specialized white blood cells. When artificially produced in laboratories and then reintroduced into the body, they have shown some promise in fighting off viruses. Interferon alfa has recently been approved by the Federal Drug Administration (FDA) for use in the treatment of Kaposi's sarcoma, a type of tumor producing bluish spots beginning on the legs, toes and feet and moving throughout the body. Kaposi's sarcoma is a cancer most commonly found in patients with the acquired immunodeficiency syndrome (AIDS). Interferons have been shown to have antiviral effects on the human immunodeficiency virus (HIV), the virus responsible for AIDS. Unfortunately, there are numerous side effects from interferon therapy, although no toxicity directed at any particular organ has been reported. Symptoms include fever, chills, flu-like feelings, loss of appetite, suppression of bone marrow blood cell production and discomfort in the stomach and intestines. A small number of patients may experience problems in heart function. Although these heart problems are not often life-threatening, there has been one report of a patient dying from heart complications the direct result of interferon therapy. In this case report, three patients having AIDS and Kaposi's sarcoma were given high doses of interferon, which resulted in poor heart functioning. Shortness of breath, chest tightness and difficulty breathing during sleep developed after beginning interferon therapy. Chest X-rays revealed heart enlargement and other heart abnormalities, and interferon therapy was discontinued. Two patients died within a year after interferon therapy was initiated and one patient continues to do well two years later. It is unclear whether interferon therapy in itself produces toxicity affecting the heart or whether the heart function is compromised by the effects of the HIV infection in combination with long-term interferon therapy.

Health aspects, AIDS (Disease), Kaposi's sarcoma, Interferon

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Increases in CD4 T lymphocytes with intermittent courses of interleukin-2 in patients with human immunodeficiency virus infection

Article Abstract:

Long term therapy of HIV patients with CD4 cell counts over 200 per cubic millimeter may benefit from intermittent courses of interleukin-2. Interleukin-2 may improve some of the immunologic abnormalities. A study of 25 HIV-infected patients who received continuous infusions of interleukin-2 for five days every eight weeks over seven to 25 months found that interleukin-2 therapy induced a 50% increase in the number of CD4 cells in six of 10 patients with baseline CD4 cell counts over 200. The most benefit was seen in patients without a severely deficient immune system and with a low viral burden. The increase in CD4 cells lasted for up to eight months in some patients and could be reinduced by additional interleukin-2 infusions. Interleukin-2 therapy was associated with a decline in the numbers CD8 cells that expressed HLA-DR. An increase in CD8 cells expressing HLA-DR may indicate a poor outcome. Therapy increased the number of cells with the interleukin-2 receptor, which may have contributed to the sustenance of the increase in CD4 cells. An antiretroviral regimen may be needed during interleukin-2 therapy.

Evaluation, Interleukin-2

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