Passive immunotherapy in advanced HIV infection and therapeutic plasmapheresis in asymptomatic HIV-positive individuals: a four-year clinical experience
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We have been treating patients with advanced HIV disease using passiveimmunotherapy (PIT). Earlier studies of PIT which have been publishedconcerned relatively short periods of treatment: our study is by far the longest and reports also on the long-term effects of plasmapheresis onhealthy HIV-infected individuals. Fifty-nine patients with an average CD4+T-cell count of 55 per cu.mm. at baseline were transfused at monthlyintervals with 500 ml of hyperimmune plasma. No disease progression ordeath occurred among the 8 asymptomatic patients under the treatment, whichlasted for 36.25 months on average. Seven of the 15 ARC patients progressedto AIDS but none died in an average period of 25.9 months. Seven of the 36symptomatic AIDS patients with advanced disease died in an average period of19.6 months. PIT appears to be nontoxic and to have beneficial effectslasting at least four years under continuous treatment. It probably delaysdisease progression in ARC and AIDS patients, and almost certainly does soin asymptomatic late HIV infection with a very low CD4+ T-cell count. Noneof the 51 donors suffered adverse effects, nor did any progress to ARC orAIDS in an average period of 30.1 months. Their laboratory parametersindicated a nearly stable condition: in particular, their average CD4+T-cell count rose from 478 to 498. The study of our plasma donors indicatedthat repeated and frequent plasma donation by asymptomatic HIV-infectedindividuals could delay disease progression, although further studies areneeded to investigate this.
- Bacchetti P, Moss AR. Incubation periods of AIDS in San Francisco.Nature 1989; 338: 251–253.
- Cao Y, Qin L, Zhane L, Safrit J, Ho D. Virological and immunological characterisation of long term survivors of HIV-1-infection. NEJ Med 1995; 332: 201–208.
- Wei X, Ghosh SK, Taylor ME, Johnson VA, Emihi EA, Deutsch P, Lifson JD, Bonhoeffer S, Nowak MA, Hahn BH, Saag MS and Shaw GM. Viral dynamics in human immunodeficiency virus type 1 infection. Nature 1995; 373: 117–122.
- Ho O, Neumann AU, Perelson AS, Chen W, Leonard JM and Markowitz M. Rapid turnover of plasma virus and CD4 lymphocytes in HIV-1 infection. Nature 1995; 373: 123–136.
- Karpas A, Gilson W, Bevan PC, Oates JK. Lytic infection by British AIDS virus and the development of rapid cell test for antiviral antibodies. Lancet 1985; 695–697.
- Karpas A, Hill F, Youle M, Cullen V, Gray J, Byron N, Hayhoe FGJ, Tenant-Flowers M, Howard L, Gilgen D, Oates J, Howkins D, Gazzard B. Effect of passive immunisation in patients with the acquired immunodeficiency syndrome-related complex and acquired immunodeficiency syndrome. Proc Natl Acad Sci USA 1988; 85: 9234–9237.
- Karpas A, Hewlett IK, Hill F, Gray J, Byron N, Gilgen D, Bally V, Oates JK, Gazzard B, Epstein JE. Polymerase chain reaction evidence for human immunodeficiency virus-1 neutralisation by passive immunisation in patients with AIDS and AIDS-related complex. Proc Natl Acad Sci USA 1990;87: 1195–1199.
- Vittecoq D, Mattinger B, Barre-Sinoussi F, Courouce AM, Rouzinoux C, Doinel C, Bary M, Viard JP, Bach JF, Rouger P, Lefrere JJ. Passive immunotherapy in AIDS: a randomised trial of serial human immunodeficieny virus-positive transfusions of plasma rich in p24 antibodies versus transfusions of seronegative plasma. J Inf Diseases 1992; 165: 364–368.
- Levy J, Youvan T, Lee ML. Passive hyperimmune therapy in the treatment of AIDS: Results of a multicentre double blind controlled trial. Blood 1994; 84: 2130–2135.
- Vittecoq D, Chevret S, Morand-Joubert L, Heshamati F, Audit F, Bary M, Dusautoir J, Bismuth A, Viard JP, Barre-Sinousi F, Bach JF, Lefrere JJ. Passive immunotherapy in AIDS. A double blind randomized study based on transfusions of plasma rich in anti-human immunodeficieny virus 1 antibodies versus transfusions of seronegative plasma. Proc Natl Acad Sci 1995; 92: 1195–1199.
- Concorde Co-ordinating Committee. Concorde: MRC/ANRS randomised double-blind controlled trial of immediate and deferred Zidovudine in symptom-free HIV infection. Lancet 1994; 343: 871–880.
- Jacobson JM, Colman N, Ostrow NA, Simson RW, Tomesch D, Marlin L, Rao M, Mills JL, Clement J, Prince A. Passive immune therapy in treatment of advanced HIV infection. J Inf Dis 1993; 168: 288–305.
- Hamilton JD, Hartigan PM, Simberkoff MS et al. A controlled trial of early versus late treatment with Zidovudine in symptomatic human immunodeficiency virus infection. New Engl J Med 1992; 326: 437–443. ai]14._ Cummins LM, Weinhold KJ, Matthews TJ, Longlois AJ, Perno GF, Condie RM, Allain JP. Preparation and characterization of an intravenous solution IgG from HIV-seropositive donors. Blood 1991; 77: 1111–1117.
- Stricker RB, Youvan TD, McGrath MF, Levy J. Potential benefit of repeated plasma donation in asymptomatic HIV-infected individuals. Proceedings of the Sixteenth Annual Meeting of the American Society of Apheresis 1995; Abstract 88, p. 112.
- Bainbridge D, Lowdell MW, Hannet IM, Strauss KW, Karpas A. Can repeated plasma donation by asymptomatic HIV-infected individuals delay the onset of AIDS? Philosophical Transactions: Royal Society Lond. B 1997; 352, 763–770.
- Passive immunotherapy in advanced HIV infection and therapeutic plasmapheresis in asymptomatic HIV-positive individuals: a four-year clinical experience
Volume 11, Issue 1 , pp 7-14
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- Kluwer Academic Publishers
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- Passive immunotherapy in HIV disease and therapeutic plasmapheresis
- Author Affiliations
- 1. New York Medical College, Valhalla, New York
- 2. Southern New England Community Consortium, 25 Valley Drive, Greenwich, Conn., 06830, USA
- 3. Department of Actuarial Mathematics and Statistics, Heriot-Watt University, Edinburgh, EH14 4AS, UK
- 4. Department of Haematology, University of Cambridge, MRC Centre, Cambridge, CB2 2QH, UK