Steroid Delays AIDS Onset in People With HIV
Prednisolone May Stall AIDS Progression by Suppressing Immune System
May 4, 2004 -- A drug that suppresses the immune system may actually help
delay the progression of HIV to AIDS, according to a new study.
Researchers found the drug, called prednisolone, significantly
slowed the loss of disease-fighting T cells that leads to full-blown AIDS and
prevented development of the disease in nearly half of the HIV-infected
patients treated for two years.
HIV infection typically causes a progressive loss of T cells,
which are involved in fighting disease. When the number of T cells fall below a
certain level, the weakened immune system is no longer able to effectively
fight off infection and AIDS develops.
Researchers say the results of the study should prompt further
clinical trials of prednisolone and other similar immune-suppressing drugs
known as glucocorticoids to determine the lowest possible dose than can
maintain a healthy supply of T cells and whether the drugs can be used in
conjunction with standard antiretroviral therapy.
Drug May Stall AIDS Progression
In this long-term follow-up of a 1992 pilot study of
prednisolone in HIV treatment, French researchers followed 44 HIV-infected
patients who were treated with the drug for 10 years. The results appear in the
May 5 issue of BMC Medicine.
After two years of taking the drug, 43% of the patients taking
it had higher T cell counts than when they entered the study. Only 5% of the 74
similarly matched HIV-infected patients in the comparison group who did not
receive prednisolone had an increase in T cells.
After five years, more than 11% of the prednisolone-treated
patients continued to have T-cell counts that were higher than when the study
began, compared with virtually none in the comparison group.
Researchers say the drug seemed most effective in patients who
had a low level of the virus in their body at the start of the study. For
example, no cases of full-blown AIDS developed within two years after the
treatment began among those with a low viral load vs. a 59% among those with a
high viral load.
In comparison, the two-year AIDS-free rates in the comparison
group were 70% and 30% among those with low or high viral loads,
Although the drug suppresses the immune system, researchers say
it did not cause the HIV virus to replicate more vigorously. Side effects of
the drug were mild at the low doses given in the study.
Researchers say prednisolone is inexpensive and may be useful
in treating HIV patients in developing countries where availability of standard
HIV medications is limited.