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Clinical: Original Papers

Immuno-activation with anti-CD3 and recombinant human IL-2 in HIV-1-infected patients on potent antiretroviral therapy

Prins, Jan M.a*; Jurriaans, Suzannec*; van Praag, Rieneke M.E.a; Blaak, Hettye; van Rij, Ronalde; Schellekens, Peter Th.A.b; ten Berge, Ineke J.M.b; Yong, Si-Lab; Fox, Cecil H.f; Roos, Marijke T.L.e; de Wolf, Frankc; Goudsmit, Jaapc; Schuitemaker, Hannekee; Lange, Joep

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Background: A stable reservoir of latently infected, resting CD4 T cells has been demonstrated in HIV-1-infected patients despite prolonged antiretroviral treatment. This is a major barrier for the eradication of HIV by antiretroviral agents alone. Activation of these cells in the presence of antiretroviral therapy might be a strategy to increase the turnover rate of this reservoir.

Methods: Three HIV-1-positive patients on potent antiretroviral therapy, in whom plasma viremia had been suppressed to below 5 copies/ml for at least 26 weeks, were treated with a combination of OKT3 (days 1-5) and recombinant human IL-2 (days 2-6).

Results: The side-effects were fever, headache, nausea, diarrhea, and in one of the patients transient renal failure and seizures. The regimen resulted in profound T cell activation. In one patient plasma HIV-1 RNA transiently increased with a peak at 1500 copies/ml. In the other two patients plasma HIV-1 RNA levels remained below the detection limit, but HIV-1 RNA levels in the lymph nodes increased two- to threefold. All patients developed antibodies against OKT3.

Conclusion: OKT3/IL-2 resulted in T cell activation and proliferation, and could stimulate HIV replication in patients having achieved prolonged suppression of plasma viremia. OKT3/IL-2 therapy was toxic and rapidly induced antibodies against OKT3.

© 1999 Lippincott Williams & Wilkins, Inc.


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