ACTG 349--Immunologic &virologic effects of prednisone on HIV-1 infection

$0M01FY2002RRNIH

Case Western Reserve University, Cleveland OH

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Abstract

The recognized effects of corticosteroids on immune function suggest that by inhibiting cellular activation, corticosteroids may inhibit HIV expression and reduce the population of potentially infectable cells. Two uncontrolled clinical trials of corticosteroids for HIV infection have suggested a beneficial effect of corticosteroids on p24 antigen levels; one of these studies also suggested a beneficial effect on CD4 cell counts. These and other studies further suggest that the risk of OIs due to prednisone may be avoided by selecting subjects with CD4 cell counts >100/mm3, limiting the dose to <60mg/day and giving preventive therapy for thrush and in selected individuals, HSV. However, these studies have not been confirmed in a randomized, double-blinded clinical study, nor to systematically evaluate immune function in prednisone-treated HIV-infected patients or the immune mechanisms that may facilitate increases in CD4 cell numbers.

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