Steinhart C R, Ash S R, Gingrich C, Sapir D, Keeling G N, Yatvin M B
Mercy Special Immunology Services, Miami, Florida, USA.
J Acquir Immune Defic Syndr Hum Retrovirol. 1996 Mar 1;11(3):271-81. doi: 10.1097/00042560-199603010-00007.
The safety and possible efficacy of extracorporeal whole-body hyperthermia (WBHT) were evaluated in the first FDA-approved feasibility study of WBHT in persons with AIDS. Six gay men, aged 20-50 years, CDC class C-3, underwent 1 h of WBHT at either 40 degrees C or 42 degrees C, employing a system that minimizes the physiological and biochemical changes that occur during WBHT. All subjects had Kaposi's sarcoma (KS), were free of opportunistic infections, and had significant elevations of plasma HIV RNA. During the treatment, there were no adverse side effects and all subjects tolerated WBHT without problems. KS lesions partially regressed immediately following WBHT in all subjects but returned to pretreatment status in five of six patients at 1 week. In subjects treated at 40 degrees C, CD4 counts decreased during the 8-week follow-up period; they remained unchanged, however, following 42 degrees C WBHT. Viral load remained unchanged following WBHT in subjects treated at 40 degrees C. Treatment at 42 degrees C resulted in an immediate reduction in HIV RNA that was not sustained at 1 week post-WBHT. We conclude that WBHT is safe in subjects with advanced HIV disease and that it may have a role in treating HIV infection. A larger controlled trial involving two treatments in less immunocompromised subjects is currently in progress to test this hypothesis.
在食品药品监督管理局（FDA）批准的首项针对艾滋病患者进行的体外全身热疗（WBHT）可行性研究中，对WBHT的安全性及可能的疗效进行了评估。六名年龄在20至50岁之间、疾病控制中心（CDC）C-3级的男同性恋者，采用了一种能将WBHT期间发生的生理和生化变化降至最低的系统，在40摄氏度或42摄氏度下接受了1小时的WBHT。所有受试者均患有卡波西肉瘤（KS），无机会性感染，且血浆HIV RNA显著升高。治疗期间，未出现不良副作用，所有受试者均顺利耐受WBHT。所有受试者在WBHT后KS病变均立即部分消退，但六名患者中有五名在1周时恢复到治疗前状态。在40摄氏度接受治疗的受试者中，CD4细胞计数在8周随访期内下降；然而，在接受42摄氏度WBHT后，CD4细胞计数保持不变。在40摄氏度接受治疗的受试者中，WBHT后病毒载量保持不变。42摄氏度的治疗导致HIV RNA立即下降，但在WBHT后1周未持续。我们得出结论，WBHT对晚期HIV疾病患者是安全的，并且可能在治疗HIV感染中发挥作用。目前正在进行一项更大规模的对照试验，在免疫功能受损较轻的受试者中进行两种治疗，以验证这一假设。
