Volume 194, number 12: Cyclosporin A Provides No Sustained Immunologic Benefit to Persons with Chronic HIV-1 Infection Starting Suppressive Antiretroviral Therapy: Results of a Randomized, Controlled Trial of the AIDS Clinical Trials Group A5138
14th Nov 2006, 00:59 GMT
Background. Although the determinants of immune deficiency and immune restoration in chronic human immunodeficiency virus (HIV)–1 infection are not well understood, immune activation has been proposed as being central to the pathogenesis of HIV. Methods. A randomized, controlled trial of cyclosporin A treatment for 2 weeks was performed in persons with chronic HIV-1 infection who were beginning a standardized antiretroviral therapy (ART) regimen. Results. Treatment with cyclosporin A provided only a marginal and transient enhancement in circulating T cell restoration that was largely restricted to cells expressing the CCR7 chemokine receptor and that did not persist beyond 2 weeks. Conclusions. Cyclosporin A coadministered for 2 weeks with ART provided no sustained immunologic benefit to persons with chronic HIV-1 infection. If immune activation drives progressive immune deficiency in chronic HIV-1 infection, these activation pathways may not be sensitive to cyclosporin.
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