Restoration of Suppressor T-Cell Functions in Children With AIDS Following Intravenous Gamma Globulin Treatment

Gupta, Asha; Novick, Brian; Rubinstein, Arye

doi:10.1001/archpedi.1986.02140160061033

Cited by 39 publications

(15 citation statements)

References 23 publications

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“…The lack of significant %CD4 decline and absence of opportunistic infections are in agreement with our retrospective evaluation of 18 HIV-TP patients on maintenance anti-D therapy followed for a median of 4.8 years [15]. Similarly, there is a large experience with monthly administration of 400 mg/kg of IVIG with beneficial clinical and immunological effects in children with HIV infection [25][26][27][28].…”

Section: Discussionsupporting

confidence: 78%

Superior effect of intravenous anti‐D compared with IV gammaglobulin in the treatment of HIV‐thrombocytopenia: Results of a small, randomized prospective comparison

Scaradavou

Cunningham‐Rundles

et al. 2006

American J Hematol

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This small, prospective, randomized study compared increases in platelet counts and duration of response after intravenous gammaglobulin (IVIG) and IV anti-D in patients with HIVrelated thrombocytopenia (HIV-TP). Nine Rh+, nonsplenectomized HIV-positive patients with thrombocytopenia were treated sequentially, in random order, with IVIG and IV anti-D in a cross over design, receiving each therapy for 3 months. Peak platelet counts and duration of effect after each treatment were compared. In addition, viral load measurements and CD4 counts were followed serially, as well as thrombopoietin levels. IV anti-D resulted in a mean peak platelet count of 77 x 10 9 /L compared to only 29 x 10 9 /L after IVIG (P = 0.07). The mean duration of response was significantly longer in patients treated with anti-D (41 days) compared to IVIG (19 days, P ¼ 0.01). No consistent changes were seen in the CD4 counts or viral load measurements as a result of either therapy. Thrombopoietin levels were normal in all patients despite often severe thrombocytopenia. Anti-D was more efficacious than IVIG for the treatment of HIV-TP, confirming and extending previous results. Anti-D should be the first line therapy in HIV-positive, Rh+ patients, when antiretroviral agents are not indicated, not effective, or there is an urgent need to increase the platelet count. Am. J. Hematol. 82:335-341, 2007. V V C 2006 Wiley-Liss, Inc.

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Section: Discussionsupporting

confidence: 78%

Superior effect of intravenous anti‐D compared with IV gammaglobulin in the treatment of HIV‐thrombocytopenia: Results of a small, randomized prospective comparison

Scaradavou

Cunningham‐Rundles

et al. 2006

American J Hematol

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“…Using IVIg in the supportive care of children with nonthrombocytopenic AIDS, immunosuppression is not seen [52], and in Ig deficient cases, it reduces the infection rate [26]. Despite reports associating infection with IVIg [53], blockade of the Fc receptor function in ITP, and in vitro changes in Ig production, circulating lymphocytes, and T4:T8 ratio [54][55][56], it seems that IVIg is a safe approach for HIV-Thr of AIDS.…”

Section: Discussionmentioning

confidence: 99%

Usefulness of a low‐dose intravenous immunoglobulin regimen for the treatment of thrombocytopenia associated with AIDS

et al. 1998

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“…In HIV-l-infected children, high-dose intravenous im munoglobulins (HD-IVIG) are known as an effective therapeutic principle in reducing the frequency of episodes of bacterial infections, fever and diarrhea [14,15,[42][43][44][45]. In adults, only few studies were done [44,[46][47][48] showing encouraging results on the clinical course but without thor ough evidence of restitution of cellular immunity.…”

Section: Introductionmentioning

confidence: 99%

“…While in pediatric AIDS the B cell defect is of major clinical importance [13][14][15], the signif icance of functional hypogammaglobulinemia in adults re mains to be elucidated. Recurrent bacterial infections [16-…”

mentioning

confidence: 99%

High-Dose Intravenous Immunoglobulins in HIV-l-Infected Adults with AIDS-Related Complex and Walter-Reed 5

Schrappe-Bächer¹,

Rasokat²,

Bauer³

et al. 1990

Vox Sanguinis

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The influence of high-dose intravenous immunoglobulins (HD-IVIG) on the clinical status and T4 cell count of adults with AIDS-related complex (ARC) and Walter-Reed 5 (WR5) was evaluated in a randomized double-blind longitudinal study. Inclusion criteria were: (1) T4 cells <400/µl and (2a) oral thrush or cutaneous anergy or (2b) two clinical ARC criteria (fever, diarrhea, weight loss, fatigue, night sweats). Thirty patients [28 males, 2 females, median age 41 (24-64) years] with ARC (n = 8), WR5 (n = 12) and both (n = 10) were stratified according to their T4 cell count (≥ vs. <300/µl). Fifteen patients received 0.4g/kg body weight IVIG and 15 placebo (albumin 0.03%) every other week for 26 weeks with follow-up for another 26 weeks. The clinical status was defined as a score consisting of fever, diarrhea, night sweats, fatigue, weight loss, oral candidiasis and mucosal or cutaneous herpes simplex. Clinical examination and routine laboratory assessments were performed before initiation of the study and before each administration, lymphocyte phenotyping every 4 weeks and cutaneous reaction, serology and lymphocyte stimulation every 12 weeks. Both groups were comparable in initial clinical symptoms and laboratory values. Seven patients developed AIDS (treatment group: 3, placebo group: 4), 1 patient died by homicide. After 26 weeks, the clinical score (particularly fatigue and fever) was significantly improved in the treatment group, while the T4 cell count and other clinical and immunological parameters remained unaltered. This limited effect was still evident at termination of the study after 52 weeks. In conclusion, HD-IVIG can improve the clinical status of patients with advanced HIV-1 infection without obviously correcting the underlying impaired cellular immunity. The substitution of intact antibodies in the state of functional hypogammaglobulinemia is suggested as possible therapeutic mechanism.

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Restoration of Suppressor T-Cell Functions in Children With AIDS Following Intravenous Gamma Globulin Treatment

Cited by 39 publications

References 23 publications

Superior effect of intravenous anti‐D compared with IV gammaglobulin in the treatment of HIV‐thrombocytopenia: Results of a small, randomized prospective comparison

Superior effect of intravenous anti‐D compared with IV gammaglobulin in the treatment of HIV‐thrombocytopenia: Results of a small, randomized prospective comparison

Usefulness of a low‐dose intravenous immunoglobulin regimen for the treatment of thrombocytopenia associated with AIDS

High-Dose Intravenous Immunoglobulins in HIV-l-Infected Adults with AIDS-Related Complex and Walter-Reed 5

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