of Work: Interleukin-2 (IL-2) is a cytokine with important regulatory properties for both T and B cells. The current studies were undertaken to evaluate interleukin-2 in the treatment of HIV infection. Our studies initially focused on patients with CD4 counts of about 200 cells/mm3 we administered IL-2 for 5 days approximately every two months at doses ranging from 6 to 18 million units/d. The courses of IL-2 were well-tolerated, although most of the patients required dosage reductions due to IL-2-related adverse effects. Sustained improvement in CD4 numbers was seen primarily in patients with >200 CD4 cells/mm3. There also was a transient increase in viral load as measured by the ratted assay seen at day 6-day 8 following initiation of IL-2 therapy. Responses in CD4 number were less common in patients with lower baseline CD4 counts. Based on the preliminary results seen in our open trial, we undertook a randomized trial to evaluate IL-2 therapy in patients with CD4 counts above 200 cells/mm in combination with currently approved anti- retroviral therapies. The study opened in April 1993 and was completed in February of 1995. with 60 patients enrolling. This study also showed in a controlled setting that intermittent therapy with IL-2 can lead to a substantial and sustained increase in CD4 cell counts without leading to an increase in plasma viral load. More recently, we have focused on improving the tolerance of IL-2, by decreasing the dose and duration of therapy, and by evaluating alternative methods of administering IL-2. We are currently developing an extension phase of ongoing studies to determine whether administration of corticosteroids with IL2 can lead to improved tolerance of IL-2 without interfering with the immunomodulatory effects. These studies are potentially important because they are the first ones to suggest that immunomodulating agents combined with anti-retroviral agents may have a benefit in patients with HIV infection.

Agency
National Institute of Health (NIH)
Institute
Clinical Center (CLC)
Type
Intramural Research (Z01)
Project #
1Z01CL000036-10
Application #
6161404
Study Section
Special Emphasis Panel (CCMD)
Project Start
Project End
Budget Start
Budget End
Support Year
10
Fiscal Year
1997
Total Cost
Indirect Cost
Name
Clinical Center
Department
Type
DUNS #
City
State
Country
United States
Zip Code
Porter, Brian O; Anthony, Kara B; Shen, Jean et al. (2009) Inferiority of IL-2 alone versus IL-2 with HAART in maintaining CD4 T cell counts during HAART interruption: a randomized controlled trial. AIDS 23:203-12
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