A Risk-Benefit Assessment of Interleukin-2 as an Adjunct to Antiviral Therapy in HIV Infection
A Risk-Benefit Assessment of Interleukin-2 as an Adjunct to Antiviral Therapy in HIV Infection
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Interleukin-2 作为 HIV 感染抗病毒治疗辅助药物的风险效益评估
作者：
S. Piscitelli;Niranjan Bhat;A. Pau
免疫调节已成为HIV研究的主要焦点，以增强，增强或恢复患者受损的免疫系统。重组白细胞介素-2目前正在HIV感染患者中进行II/III期试验。几项临床研究表明，间歇性方案与CD 4+细胞计数显著升高相关，而病毒载量未增加。大多数研究采用连续5天的白细胞介素-2治疗，通过连续静脉输注或皮下注射，每8周重复一次。另一种策略是每天给予低剂量的白细胞介素-2，但这种方案的临床经验是有限的。白细胞介素-2的管理可以产生不利影响，几乎每一个器官系统，需要积极的支持护理。各种管理策略和干预措施正在评估，以尽量减少toxicity.Currently，没有临床终点数据白细胞介素-2在HIV感染患者。在III期研究完成之前，白细胞介素-2可以作为免疫调节剂和抗逆转录病毒治疗的辅助药物用于研究。其激活潜伏感染细胞和促进从水库地点根除艾滋病毒的潜力也是进一步研究的一个重要领域。如果能证实临床获益，白细胞介素-2可作为抗逆转录病毒治疗的辅助治疗，如果不良反应可以最小化，治疗可以不经常在门诊进行。
Immunomodulation has become a major focus of HIV research in an effort to augment, boost or restore the patient’s damaged immune system. Recombinant interleukin-2 is currently being studied in phase II/III trials in HIV-infected patients. Several clinical studies have demonstrated that intermittent regimens are associated with marked rises in CD4+ cell counts without an increase in viral load. Most of these studies employ 5 consecutive days of interleukin-2 therapy by continuous intravenous infusion or subcutaneous injection, repeated every 8 weeks. An alternative strategy is the daily administration of low doses of interleukin-2, but clinical experience with this regimen is limited.Interleukin-2 administration can adversely affect virtually every organ system, requiring aggressive supportive care. A variety of administration strategies and interventions are being evaluated to minimise toxicity.Currently, no clinical end-point data are available for interleukin-2 in HIV-infected patients. Until phase III studies are completed, interleukin-2 can be used in the research setting as an immunomodulator and adjunct to antiretroviral therapy. Its potential to activate latently infected cells and promote HIV eradication from reservoir sites is also an important area for further study. If clinical benefit can be demonstrated, interleukin-2 could be useful as an adjunct to antiretroviral therapy if adverse effects can beminimised and therapy can be given infrequently on an outpatient basis.
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影响因子：
56.9
作者：
SMITH, KA
通讯作者：
SMITH, KA
DOI：
10.1073/pnas.95.15.8869
发表时间：
1998-07-21
影响因子：
11.1
作者：
Chun, TW;Engel, D;Fauci, AS
通讯作者：
Fauci, AS
合理的白细胞介素2治疗。
DOI：
--
发表时间：
1997
期刊：
The cancer journal from Scientific American.
影响因子：
--
作者：
Smith,KA
通讯作者：
Smith,KA
影响因子：
56.9
作者：
Wong, JK;Hezareh, M;Richman, DD
通讯作者：
Richman, DD
低剂量白细胞介素-2 聚乙二醇衍生物在调节人类免疫缺陷病毒 1 型感染患者免疫反应中的功效。
DOI：
10.1093/infdis/167.2.291
发表时间：
1993
期刊：
The Journal of infectious diseases
影响因子：
--
作者：
Teppler,H;Kaplan,G;Smith,K;Cameron,P;Montana,A;Meyn,P;Cohn,Z
通讯作者：
Cohn,Z