Steroid Delays AIDS Onset in People With HIV

Prednisolone May Stall AIDS Progression by Suppressing Immune System

Medically Reviewed by Michael W. Smith, MD on May 04, 2004
From the WebMD Archives

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, respectively.

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.

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SOURCES: Andrieu, J. BMC Medicine, May 5, 2004; vol 2. News release, BioMedCentral.

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