Schulof R S, Parenti D M, Simon G L, Paxton H, Meyer W A, Schlesselman S B, Courtless J, LeLacheur S, Sztein M B
Division of Hematology and Oncology, George Washington University Medical Center, Washington, D.C. 20037.
J Acquir Immune Defic Syndr (1988). 1990;3(5):485-92.
We evaluated the clinical, immunologic, and virologic effects of oral treatment with ribavirin and isoprinosine for up to 3 months in asymptomatic, HIV-culture-positive homosexual men. Fifteen consecutive men received isoprinosine 4 g/day (1 g q.i.d.), and 800 (9 men) or 1,200 mg/day (6 men) of ribavirin. Five men in each ribavirin dosage group completed at least 2 months of treatment. No unexpected toxicities were observed. Eight minor HIV-related events occurred in six men while on study. All men remained HIV-positive, and time to positive culture decreased by at least 4 days in three men from each treatment group. Serum p24 levels did not change in two men who were p24 antigenemic and received 800 mg/day of ribavirin. Treatment was associated with a generalized lymphopenia affecting all lymphocyte subsets including CD4, which was partially reversible 1 month after stopping treatment. Most of the men remained anergic on DTHS skin testing. No improvements were noted in in vitro lymphoproliferative responses to antigens or in NK cell activity (which decreased significantly in the 1,200 mg/day ribavirin group). Although well tolerated at the doses employed, the combination of ribavirin and isoprinosine produced an unexpected generalized lymphopenia and did not exhibit HIV-suppressive or immunorestorative effects.
我们评估了利巴韦林和异丙肌苷口服治疗长达3个月对无症状、HIV培养阳性的同性恋男性的临床、免疫和病毒学影响。连续15名男性接受4 g/天的异丙肌苷（1 g，每日4次），以及800 mg/天（9名男性）或1200 mg/天（6名男性）的利巴韦林。每个利巴韦林剂量组中有5名男性完成了至少2个月的治疗。未观察到意外的毒性反应。在研究期间，6名男性出现了8起与HIV相关的轻微事件。所有男性仍为HIV阳性，每个治疗组中有3名男性的培养阳性时间至少缩短了4天。两名p24抗原阳性且接受800 mg/天利巴韦林治疗的男性，其血清p24水平未发生变化。治疗与全身性淋巴细胞减少有关，影响包括CD4在内的所有淋巴细胞亚群，在停药1个月后部分可逆。大多数男性在迟发型超敏皮肤试验中仍无反应。对抗原的体外淋巴细胞增殖反应或NK细胞活性（在1200 mg/天利巴韦林组中显著降低）均未观察到改善。尽管在所使用的剂量下耐受性良好，但利巴韦林和异丙肌苷的联合使用产生了意外的全身性淋巴细胞减少，且未表现出HIV抑制或免疫恢复作用。
