Mastroianni A, Cancellieri C, Allegrini F, Pignatari S; International Conference on AIDS.
Int Conf AIDS. 2002 Jul 7-12; 14: abstract no. WePeA5799.
Division of Infectious Diseases, G.B. Morgagni General Hospital, Piazza Solieri 1, Italy
OBJECTIVE: The aim of this study was to investigate the use of long-term treatment with low-dose rHuGM-CSF to prevent severe neutropenia and related infectious complications in leukopenic patients (pts) treated with nucleoside analogues-based HAART regimens and prophylaxis for opportunistic infections. METHODS: From January 1997 through December 2001 we enrolled in this study 28 HIV+ pts (26 males, 2 females, range of age 26-53 years) with a mean absolute neutrophil count (ANC) of 600/L (range, 500-800), recognized at high risk to develop severe neutropenia and related infectious complications. Two delivery schedules were tested. In the first type a total weekly dose of 600 mcg (300 mcg every 3 days) of rHuGM-CSF was delivered in 17 pts with an ANC >500<700 neutrophils/mmc at baseline. We further tested a second dose schedule of 150 mcg of rHuGM-CSF administered two times weekly every three days in 11 pts with an AN >700<900 neutrophils/mmc.ANC was eveluated weekly during the first month and every two weeks subsequently. All pts were treated with nucleoside analogues-based HAART regimens associated with use of TMP-SMX, and/or pyrimethamine,and/or ganciclovir, and/or amphotericin B. RESULTS: Pts received rHuGM-CSF for 4-32 weeks (median 8 weeks) without loss of effect. Overal a complete response defined by a stable ANC of 1,500 neutrophils/mmc was observed in all cases. rHuGM-CSF-related side effects were recognized in 65% of pts, including fever and bone pain. No pt presented severe neutropenia or infectious complications. No pt presented a modified HIV viral load,while there was evidence of a moderate increase of the CD4+ lymphocytes count. CONCLUSION: The results of this study suggest that long-term treatment with lo-dose rHuGM-CSF may reverse drugs-related neutropenia in pts treated with HAART and prophylaxis for opportunistic infections. Long-term immunotherapy with rHuGM-CSF may also induce an improvement in the CD4+ cells count in pts receiving HAART regimens.
Publication Types:
Keywords:
- AIDS Vaccines
- Acquired Immunodeficiency Syndrome
- Antiretroviral Therapy, Highly Active
- CD4-Positive T-Lymphocytes
- Clinical Protocols
- Disease Progression
- Female
- Fever
- Ganciclovir
- HIV Infections
- HIV Seropositivity
- Humans
- Male
- Neutropenia
- Neutrophils
- Opportunistic Infections
- drug therapy
- prevention & control
- therapy
Other ID:
UI: 102259381
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