Ketotifen in HIV-infected patients: effects on body weight and release of TNF-α

Abstract

Objective: Tumor necrosis factor alpha (TNF-α) is involved in the genesis of HIV-associated malnutrition. We performed an open-label trial on the effects of ketotifen, an in vitro inhibitor of TNF-α release from peripheral blood mononuclear cells (PBMCs), on the nutritional status and TNF-α release of HIV-infected subjects.

Patients:

Six HIV-infected subjects received oral ketotifen 4 mg per day for 84 days and were followed up for an additional 70-day period. Body composition was measured by bioelectrical impedance analysis. TNF-α plasma levels, TNF-α release from PBMCs, and plasma concentration of soluble TNF receptors were measured repeatedly during the study and control period.

Results:

During ketotifen intake, TNF-α release from stimulated PBMCs significantly decreased (68 vs 155 pg ml⁻¹), but not TNF-α and soluble TNF receptor plasma concentrations. Subjects gained weight (+ 2.7 kg), whereas weight loss was observed after cessation of treatment (−1.6 kg).

Conclusion:

Ketotifen inhibits TNF-α release from stimulated PBMCs and might thus be useful in the management of HIV-associated malnutrition.