Effects of tapering doses of oral prednisone on viral load among HIV-infected patients with unexplained weight loss.

Abstract

In an exploratory study of virologic and immunomodulatory effects of corticosteroid therapy for wasting syndrome, four HIV-infected adults with recent unexplained weight loss were given tapering doses of prednisone over a 2-month period. Serum neopterin and TNF receptor II levels decreased from baseline after 7 days. An antiretroviral effect was observed initially, peaking on days 14-21 (mean change in HIV-1 branched chain DNA assay on day 21 of -0.52 log10; mean change, from baseline to nadir for each individual, of -0.63 log10); subsequent bDNA levels returned toward baseline as prednisone was tapered. No patient lost weight and there was a mean weight gain of 3.5 kg. Anecdotal reports of corticosteroid benefits in the wasting syndrome may result in part from decreased T cell activation leading to decreased HIV replication, an effect that may be self-limited or that may occur only at higher prednisone doses. Studies involving more targeted immunomodulatory agents for wasting syndrome are warranted.

• Authors: J M Kilby, P B Tabereaux, V Mulanovich, G M Shaw, R P Bucy, M S Saag
• Journal: AIDS research and human retroviruses (AIDS Res Hum Retroviruses) Vol. 13 Issue 17 Pg. 1533-7 (Nov 20 1997) ISSN: 0889-2229 [Print] United States
• PMID: 9390753 (Publication Type: Clinical Trial, Journal Article, Research Support, U.S. Gov't, P.H.S.)

Chemical References

• Neopterin
• Prednisone

Topics

• Adult
• CD4 Lymphocyte Count
• Dose-Response Relationship, Drug
• Female
• HIV Wasting Syndrome (drug therapy, immunology)
• Humans
• Male
• Neopterin (metabolism)
• Prednisone (administration & dosage, adverse effects, therapeutic use)
• Weight Loss