7th Annual Conference Of The British HIV Association [BHIVA] 27 – 29 April 2001, The Hove Centre, Brighton

[AUTHOR(S):] AK Sullivan¹, N Imami², G Hardy², C Burton², A Pires², MR Nelson¹, R Moss³, FM Gotch², BG Gazzard^1
1 Chelsea and Westminster Hospital, London, UK, ² Imperial College School of Medicine , London, UK, ³ Immune Response Corporation, San Diego, California, USA

BHIVA Conf 2001 Apr 27-29;7:O26

OBJECTIVE: To assess the acute effects of interleukin (IL)-2 therapy on CD4 cell count and viral load, and subsequent effect on the lymphoproliferative responses (LPR) to HIV-1 specific antigens in HIV-1 infected patients on virologically successful, highly active antiretroviral therapy (HAART) with or without a therapeutic vaccine (Remune).

METHODS: Patients received IL-2 (5 MU subcutaneously twice a day, for 5 days, three 4-weekly cycles) ± Remune (100 µg intramuscularly, weeks 0 and 12). Samples were taken on days 1 and 5 of each cycle and weeks 12 and 24 for CD4 cell count, viral load (VL) and HIV-1 specific LPR.

RESULTS: Fifteen patients received 41 cycles of IL-2 therapy; six patients also received Remune; 10/15 patients had at least one IL-2 associated viral blip (total 14 blips); four patients had no blips detected (three taking Remune). One patient had baseline VL=100 copies/ml. The median CD4 cell count rose from 377 to 922 cells/µl (P=0.002), but fell acutely on day 5 from 489 to 421 cells/µl (NS). Overall, the median VL remained below detection (BLD). For all IL-2 cycles, the VL rose acutely on day 5 from BLD to 122 copies/ml (P=0.002, range <50–355 copies/ ml). Mean HIV-1 specific responses increased: stimulation index (SI) at baseline and week 24 for nef: 2 to 15 (P=0.036), gp120: 2 to 7 (p=0.047) and p24: 4 to 22 (P=0.057) (SI >5 is significant). Of 10 patients with IL-2 associated blips, seven had significant p24 responses, and five maintained them to 24 weeks.

CONCLUSION: IL-2 therapy was associated with controlled viral blips and an increase in HIV-1 specific LPR in patients receiving HAART with or without Remune. There was a significant CD4 cell count rise but the VL remained BLD at 24 weeks.

PRESENTING AUTHOR: AK Sullivan

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