Cyclosporin A provides no sustained immunologic benefit to persons with chronic HIV-1 infection starting suppressive antiretroviral therapy: results of a randomized, controlled trial of the AIDS Clinical Trials Group A5138.

TitleCyclosporin A provides no sustained immunologic benefit to persons with chronic HIV-1 infection starting suppressive antiretroviral therapy: results of a randomized, controlled trial of the AIDS Clinical Trials Group A5138.
Publication TypeJournal Article
Year of Publication2006
AuthorsLederman MM, Smeaton L, Smith KY, Rodriguez B, Pu M, Wang H, Sevin A, Tebas P, Sieg SF, Medvik K, Margolis DM, Pollard R, Ertl HCJ, Valdez H
JournalJ Infect Dis
Volume194
Issue12
Pagination1677-85
Date Published2006 Dec 15
ISSN0022-1899
KeywordsAdult, Anti-Retroviral Agents, Chronic Disease, Cyclosporine, Drug Administration Schedule, Drug Therapy, Combination, Female, HIV Infections, HIV-1, Humans, Immunosuppressive Agents, Lymphocyte Count, Male, Middle Aged, Receptors, Chemokine, T-Lymphocytes, Treatment Outcome
Abstract

BACKGROUND: Although the determinants of immune deficiency and immune restoration in chronic human immunodeficiency virus (HIV)-1 infection are not well understood, immune activation has been proposed as being central to the pathogenesis of HIV.

METHODS: A randomized, controlled trial of cyclosporin A treatment for 2 weeks was performed in persons with chronic HIV-1 infection who were beginning a standardized antiretroviral therapy (ART) regimen.

RESULTS: Treatment with cyclosporin A provided only a marginal and transient enhancement in circulating T cell restoration that was largely restricted to cells expressing the CCR7 chemokine receptor and that did not persist beyond 2 weeks.

CONCLUSIONS: Cyclosporin A coadministered for 2 weeks with ART provided no sustained immunologic benefit to persons with chronic HIV-1 infection. If immune activation drives progressive immune deficiency in chronic HIV-1 infection, these activation pathways may not be sensitive to cyclosporin.

DOI10.1086/509261
Alternate JournalJ. Infect. Dis.
PubMed ID17109339
Grant ListAI 25868 / AI / NIAID NIH HHS / United States
AI 25879 / AI / NIAID NIH HHS / United States
AI 36219 / AI / NIAID NIH HHS / United States
AI 38858 / AI / NIAID NIH HHS / United States
AI 50410 / AI / NIAID NIH HHS / United States
RR 00046 / RR / NCRR NIH HHS / United States
RR 00080 / RR / NCRR NIH HHS / United States