AEGiS-11IAC: Impact of palliative corticoid therapy in advanced HIV disease on HIV-1 RNA in plasma.

11th International AIDS Conference

Vancouver, British Columbia — July 7-12, 1996

Impact of palliative corticoid therapy in advanced HIV disease on HIV-1 RNA in plasma.

Int Conf AIDS 1996 Jul 7-12; 11:223 (abstract no. Th.B.195)
Poppinger J, Wolf M, Virgin G, Jaegel-Guedes E, Jaeger H; KIS, Curatorium for Immunedeficiency, Munich, Germany. Fax: +49-89-5503941.

INTRODUCTION: Cortisone is a frequently used compound in palliative HIV therapy. There are concerns, however, that cortisone as an immunomodulating agent might increase HIV replication.

OBJECTIVE: To evaluate the effects of Prednisolone treatment on HIV viral load measured by branched DNA technology.

METHODS: A retrospective analysis of patients who were treated with Prednisolone for palliative reasons was performed. Patients were included if their CD4 cell count was below 50/microliter and if steroid treatment was started between January 1, 1995 and December 31, 1995.

RESULTS: N=69 patients were included in this analysis. All patients were at stage CDC 3C at time of initiation of cortisone treatment. Mean treatment time with Prednisolone was 4.0 months (plus or minus 2.1), mean dosage was 25.2 mg per day. Mean CD4 cell count at start of therapy was 28/microliter, mean HIV RNA was 450E3 Eq/ml. All patients were treated with anti-retrovirals during the course of their HIV disease, at time of Prednisolone therapy 42 patients were treated with antivirals. Mean pre-treatment time with antivirals at start of Prednisolone therapy was 15.2 months. Changes in HIV RNA and CD4 cells between the different antiviral strategies were not statistically significant. In the first 3 months of Prednisolone treatment HIV viral load increased by an average of 0.05 log. HIV RNA changes in plasma after 6, 9 and 12 months were -0.2 log, -0.1 log and 0.03 log respectively. The differences in HIV viral load between baseline and treatment measurements were not statistically significant. In the first 3 months of Prednisolone treatment there was a mean decrease in CD4 cells of 0.78 CD4 cells per microliter. The change of CD4 cells between baseline and month 3 was statistically not significant.

CONCLUSIONS: In this small retrospective analysis Prednisolone treatment did not significantly increase HIV viral load, significant changes in CD4 cells were not observed. Prospective and controlled trials seem to be warranted to further evaluate the influences of Prednisolone treatment on viral load in advanced HIV patients.

Keywords: AEGIS, HIV Infections, Viral Load, CD4 Lymphocyte Count, Antiretroviral Therapy, Highly Active, Virus Replication, Retrospective Studies, Human, virology, ICA11

960707
ThB195