Volume 11 Supplement 1

Abstracts of the Ninth International Congress on Drug Therapy in HIV Infection

Open Access

Clinical effect of interleukin-2 (IL-2) immuno-adjuvant treatment in HIV+ advanced naïve patients

  • C Tincati1,
  • M Cesari2,
  • L Meroni2,
  • F Bai1,
  • GM Bellistrì1,
  • M Galli2,
  • ME Moroni2,
  • A d'Arminio Monforte1 and
  • GM Marchetti1
Journal of the International AIDS Society200811(Suppl 1):P1

DOI: 10.1186/1758-2652-11-S1-P1

Published: 10 November 2008

Purpose of the study

The risk of opportunistic infections and inefficient immune reconstitution in advanced naive HIV+ patients starting HAART are critical issues in the management of HIV infection. We studied the effects of IL-2 adjuvant therapy in favoring a rapid CD4 cell rescue, shortening the time frame at highest risk of HIV-related clinical events in patients with severe immune impairment.

Methods

After 2 weeks of HAART, 73 HAART-naive patients with baseline CD4 cells <200/μL were randomized to receive IL-2+HAART (n = 33) or to continue ongoing HAART (n = 40). Three cycles of IL-2 were administered (one cycle: 3 × 106 IU QD sc at days 1–5 and 8–12), for an overall duration of 3 months. Patients were followed-up over 18 months. Patients failing to show a sustained CD4 recovery of >30% from baseline after 6 months (IL-2 non-responders, IL-2NR) received three further IL-2 cycles.

Summary of results

At baseline, IL-2 and HAART-control patients were comparable in terms of median CD4 counts (61/μL and 48/μL, respectively, p = 0.23) and prevalence of patients with AIDS-defining conditions (HAART-controls: 27; IL-2 patients: 15, p = 0.1). Rapid HIV-RNA decrease with no rebounds was observed in both IL-2 and HAART-patients. Major results are shown in Table 1. Compared to HAART-controls, IL-2 resulted in a more significant and rapid CD4 rescue after 3 months (p = 0.01). However, response to IL-2 was not equally persistent among patients: IL-2R displayed a higher and more sustained CD4 recovery up to month 18 respect to IL-2NR (p = 0.01) and controls (p = 0.04). Three additional cycles in IL-2NR did not result in any further significant CD4 recovery. During study period, AIDS-defining events were diagnosed in six (15%) HAART-controls and in one (3%) IL-2+HAART patient (p = 0.06).

Table 1

Group

Median CD4/μL change from BL (T3 mths)

Median CD4/μL change from BL (T6 mths)

Median CD4/μL change from BL (T18 mths)

IL-2+HAART patients (n = 33)

+145

+59

+107

IL-2R (n = 23/33)

+161

+91

+135

IL-2 NR (n = 10/33)

+95

+28

+74

HAART controls (n = 40)

+20

+59

+97

Conclusion

In advanced naïve patients, IL-2 adjuvant therapy is efficacious in inducing a rapid and significant CD4 reconstitution, in most cases sustained up to 18 months. The finding of a reduced prevalence of patients developing AIDS-defining conditions suggests a possible efficacy in functional immune enhancement which may translate into earlier clinical benefit.

Authors’ Affiliations

(1)
Ospedale San Paolo, University of Milan
(2)
Ospedale L. Sacco, University of Milan

Copyright

© Tincati et al; licensee BioMed Central Ltd. 2008

This article is published under license to BioMed Central Ltd.

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