Markowitz Norman, Bebchuk Judith D, Abrams Donald I
Division of Infectious Diseases, Henry Ford Hospital, Detroit, Michigan 48202, USA.
Clin Infect Dis. 2003 Oct 15;37(8):e115-20. doi: 10.1086/378293. Epub 2003 Sep 24.
Community Program for Clinical Research on AIDS 059 was a multicenter study conducted among human immunodeficiency virus (HIV)-infected individuals with CD4+ cell counts > or =300 cells/mm3 who were randomly assigned to receive antiretroviral therapy with or without intermittent subcutaneously administered recombinant interleukin-2 (rIL-2). To identify factors associated with a response to IL-2, a secondary analysis was performed that included the subset of rIL-2 recipients who were able to complete all 3 initial treatment cycles. Predictors of a change in CD4+ cell count between baseline and 1 month after the start of treatment cycle 3 were examined in a multivariate model that included sex, race, body surface area, rIL-2 dose, HIV load, and both baseline and nadir CD4+ cell count. The combination of race and sex (P=.027) and the nadir CD4+ cell count (P=.005) were significant predictors of mean CD4+ cell count response. Baseline CD4+ cell count had no significant effect. The strong association between nadir CD4+ cell count and CD4+ cell count response suggests that immunologic losses resulting from HIV-mediated CD4+ cell depletion may be irreversible.
艾滋病临床研究社区项目059是一项多中心研究，在CD4 +细胞计数≥300个细胞/mm3的人类免疫缺陷病毒（HIV）感染者中进行，这些感染者被随机分配接受抗逆转录病毒治疗，部分接受或不接受间歇性皮下注射重组白细胞介素-2（rIL-2）。为了确定与IL-2反应相关的因素，进行了一项二次分析，该分析纳入了能够完成所有3个初始治疗周期的rIL-2接受者亚组。在一个多变量模型中检查了治疗周期3开始后1个月与基线之间CD4 +细胞计数变化的预测因素，该模型包括性别、种族、体表面积、rIL-2剂量、HIV载量以及基线和最低点CD4 +细胞计数。种族和性别的组合（P = 0.027）以及最低点CD4 +细胞计数（P = 0.005）是平均CD4 +细胞计数反应的显著预测因素。基线CD4 +细胞计数没有显著影响。最低点CD4 +细胞计数与CD4 +细胞计数反应之间的强关联表明，HIV介导的CD4 +细胞耗竭导致的免疫损失可能是不可逆的。
