OBJECTIVE: DDTC, a thiocarbamate, is a potent inhibitor of NFKB activation by cytokines: tumor necrosis factor Il-1 and Il-6. Acyclovir inhibits reactivation of herpetic viruses. Both NFKB and herpetic viruses are known to transactivate HIV in vitro. We report preliminary findings using DDTC and ACV in HIV positive subjects followed for an average of 46 months and compared these to seven retrospectively matched individuals who elected to take no therapy (observation period 43 mos.) METHOD: 18 HIV subjects with initial CD4 counts 150-500 were followed in an office setting for an average of 45 months (24-85). Patients took a combination of DDTC (10-12.5 mgm/kg once weekly) and ACV (400 mgm t.i.d.). Subjects were monitored at two monthly intervals for surrogate markers including CD4 and CD8 lymphocytes and acid labile alpha interferon (AL-Ifn). PCP prophylaxis was given to patients with less than 200 CD4 cells. Patients took no nucleoside analogues. RESULTS: No patients developed opportunistic infections, one patient developed lymphoma. CD4 counts showed relative stability in the treatment group (mean decline 308-265) over the observation period compared to the control group (402-49). Presence of AL-Ifn in subjects at time of treatment initiation indicated non- stabilization and progression of disease. Conclusion: Our observations suggest that a combination of DDTC/ACV will stabilize CD4 counts and maintain a clinically asymptomatic state in patients with initial CD4 counts 150-500. Controlled studies are indicated to confirm these observations.

CD4 Lymphocyte Count Didanosine/*THERAPEUTIC USE Drug Therapy, Combination Giant Cells/*VIROLOGY Human HIV Infections/DRUG THERAPY HIV-1/*PATHOGENICITY Phenotype Treatment Outcome Zalcitabine/*THERAPEUTIC USE Zidovudine/*THERAPEUTIC USE ABSTRACT

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