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Dr. Oliver, regarding the "off label" use of IVIG (intravenous immunoglobulin) for AIDS, I have used IVIG for primary immunodeficiencies (agammaglobulinemia, hypogammaglobulinemia), and for passive immunization for symptomatic HIV patients exposed to measles, H. zoster, or who have tetanus-prone wounds, but not routinely as a treatment for AIDS. I basically use Gammagard IgG (no IgA) [Baxter] for IgG/IgA deficiencies since these patients have IgE anti-A antibodies. At a dosage of approx 400 mg/kg (ave 30 gms) monthly, the cost varies from about $1100 to $2500/mos., which exceeds the cost of acceptable HIV/AIDS combo drug therapy. In what AIDS patients do you generally use IVIG therapy and do you use other biologic and pharmacologic agents, such as Pentoxifyline, to modulate the immune system? Interferon gamma is used in AIDS-related Kaposi sarcoma. Interleukin-2 is a potent cytokine that regulates T-cell and B-cell immune responses; however, it has severe toxic side-effects. Interleukin 3,4,7 are in phase 2 clinical trials as adjunct therapy for AIDS. Do you know of any results so far? DISCLAIMER: The above is for general discussion only and is not meant to reflect/imply any recommendations for the treatment of AIDS patients, who should be treated on an individual basis. |
