Kaposi's sarcoma and AIDS: Treatment with interferon-α Journal Article
| Author: | Krown, S. E. |
| Article Title: | Kaposi's sarcoma and AIDS: Treatment with interferon-α |
| Abstract: | Interferon-α can be considered the initial treatment of choice for a relatively small subset of persons who present with Kaposi's sarcoma as the sole manifestation of HIV-1 infection. In addition to lacking lymphoma-like 'B' symptoms and opportunistic infections, appropriate candidates for interferon-α therapy generally have a relatively high level of residual immunocompetence. The role of interferon-α as an antiretroviral agent, alone or in combination with other drugs, is less well defined. There are indications, based on the experience in Kaposi's sarcoma, that interferon's antiretroviral effects are most likely to be observed in patients at a quite early stage of HIV-1 infection. A preliminary study suggests that interferon-α may have clinically important antiretroviral effects in asymptomatic seropositive persons with high CD4 counts and may prevent the decline in CD4 counts with time, but more studies are needed to confirm these observations and to assess the relative efficacy of interferon-α with respect to agents such as zidovudine that inhibit HIV-1 growth at a different stage of the virus replication cycle. A particularly promising area of investigation is the use of interferon-α together with zidovudine, or with other reverse transcriptase inhibitors. Synergistic antiretroviral effects have been observed in vitro and in a murine system, and studies are in progress to formally address the issue of antiretroviral synergy in HIV-1-infected persons. Although optimal drug combinations have yet to be defined, the early results of phase I trials suggest that the interferon-α and zidovudine combination may be more effective against Kaposi's sarcoma than interferon-α alone and that therapeutic effects may be observed in some patients with low CD4 counts who would have been unlikely to respond to single-agent interferon-α. There is also evidence that the state of activation of the endogenous interferon system may be an important determinant of responsiveness to interferon-α and interferon-containing combinations. Issues of drug toxicity, chiefly neutropenia, remain significant, and future investigations will need to address the role of hematopoietic colony-stimulating factors and the use of other nucleoside analogues in devising more tolerable and effective combination regimens. |
| Keywords: | alpha interferon; neurotoxicity; antineoplastic agent; anorexia; alpha2b interferon; liver toxicity; anemia; bone marrow suppression; etoposide; nausea; vinblastine; dactinomycin; bleomycin; acquired immune deficiency syndrome; kaposi sarcoma; alpha2a interferon; influenza; zidovudine; intramuscular drug administration; subcutaneous drug administration; human; article |
| Journal Title: | AIDS Updates |
| Volume: | 4 |
| Issue: | 4 |
| ISSN: | 1040-6247 |
| Publisher: | J.B. Lippincott Co. |
| Date Published: | 1991-07-01 |
| Start Page: | 1 |
| End Page: | 8 |
| Language: | English |
| PROVIDER: | scopus |
| DOI/URL: | |
| Notes: | Article -- Export Date: 27 September 2019 -- Source: Scopus |
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