免疫学和病毒学效应,皮下介质素2与抗逆转录病毒治疗结合:一个随机对照试验
R T Davey1, R L Murphy, F M Graziano
1National Institutes of Health, Bethesda, MD 20892-1880, USA. rdavey@niaid.nih.gov
JAMA
|July 13, 2000
概括
与抗逆转录病毒疗法 (ART) 结合的英特勒素2 (IL-2) 与单独的ART相比,显著提高了HIV患者的CD4细胞计数和病毒抑制. 需要进一步的试验来确认临床益处.
科学领域:
- 免疫学 免疫学 免疫学
- 病毒学 病毒学
- 临床医学 临床医学
背景情况:
- 互白素2 (IL-2) 可以扩大CD4T淋巴细胞池.
- 关于IL-2对治疗艾滋病毒的强效抗逆转录病毒疗法 (ART) 的附加益处的数据有限.
研究的目的:
- 评估IL-2与ART结合对CD4细胞恢复和病毒抑制的影响.
- 在艾滋病毒感染个体中,比较IL-2加ART与单独ART的疗效.
主要方法:
- 一个随机的,受控的多中心试验,涉及82名艾滋病毒阳性成人门诊患者.
- 参与者的基线CD4计数在200-500细胞/毫米3之间,RNA水平<10,000副本/毫升.
- 干预包括皮下IL-2与ART或单独ART一起进行一年的干预.
主要成果:
- 结合IL-2治疗导致CD4计数增加了112%,而单独使用ART则增加了18% (P<.001).
- 与对照组 (20.4%至23.0%) 相比,IL-2组的CD4百分比显著增加 (20.4%至32.3%).
- 病毒载量在IL-2组下降了-0.28 log(10) 副本,而对照组增加了0.09 log(10) 副本 (P=.03);67%的IL-2患者实现了病毒载量<50副本/毫升,而对照组的36% (P=.02) 实现了病毒载量<50副本/毫升.
结论:
- 与单独的ART相比,间歇性IL-2和ART治疗显著提高了CD4细胞计数和病毒载量减少.
- 进一步的临床试验至关重要,以确定这些免疫学和病毒学改善是否转化为更好的临床结果.
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