Stadler R, Bratzke B, Schaart F, Orfanos C E
Department of Dermatology, University Medical Center Steglitz, Free University of Berlin, F.R.G.
J Invest Dermatol. 1990 Dec;95(6 Suppl):170S-175S. doi: 10.1111/1523-1747.ep12875494.
Interferon alpha (IFN-alpha) has been shown to be effective in treating HIV-associated KS in at least 30% of patients, and Zidovudine has proved beneficial for AIDS patients. Moreover, both drugs have demonstrated an inhibitory effect on HIV replication. Based on the above, we combined IFN-alpha and zidovudine for treatment of HIV-associated KS in order to evaluate tolerance and clinical efficacy. Twenty-one homosexual men with histologically proved HIV-associated KS were treated in an open trial with rIFN-alpha-2a 18 X 10(6) IU every second day and zidovudine 800-1200 mg/d. Treatment was discontinued within the first month in six patients: three of them developed subjective intolerance, and three others contracted severe opportunistic infections or HIV-cachexia. Fifteen evaluable patients received combination treatment over a period of 2-20 months (average 10 months). The dosage was reduced as required based on drug-induced cytotoxicity. Complete remission was observed in four patients, partial remission in three, stable disease in two, and progression in six, resulting in an overall response rate of 46%. Negative p24 expression prior to treatment was a positive predictor. Although extracutaneous involvement had a negative influence on tumor remission, even patients with a mean initial T-helper cell count below 100 mm3 responded positively. In conclusion, combination therapy of rIFN-alpha-2a with AZT may effectively control HIV-related Kaposi's sarcoma in more than 40% of patients. In contrast to monotherapy with IFN-alpha, patients with severely reduced immune systems will also benefit from combined treatment.
α干扰素（IFN-α）已被证明在至少30%的患者中对治疗与HIV相关的卡波西肉瘤有效，齐多夫定已被证明对艾滋病患者有益。此外，这两种药物都对HIV复制有抑制作用。基于上述情况，我们联合使用IFN-α和齐多夫定治疗与HIV相关的卡波西肉瘤，以评估耐受性和临床疗效。21名经组织学证实患有与HIV相关的卡波西肉瘤的同性恋男性在一项开放试验中接受治疗，每两天注射18×10⁶IU的重组IFN-α-2a，同时每天服用800 - 1200mg齐多夫定。6名患者在第一个月内停止治疗：其中3名出现主观不耐受，另外3名感染了严重的机会性感染或出现了HIV恶病质。15名可评估的患者接受了2至20个月（平均10个月）的联合治疗。根据药物诱导的细胞毒性，必要时减少剂量。4名患者完全缓解，3名部分缓解，2名病情稳定，6名病情进展，总缓解率为46%。治疗前p24表达阴性是一个积极的预测指标。尽管皮肤外受累对肿瘤缓解有负面影响，但即使初始平均T辅助细胞计数低于100/mm³的患者也有积极反应。总之，重组IFN-α-2a与齐多夫定的联合治疗可有效控制40%以上患者的HIV相关卡波西肉瘤。与IFN-α单药治疗不同，免疫系统严重受损的患者也将从联合治疗中受益。
