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Biotech / Medical : IMNR - Immune Response -- Ignore unavailable to you. Want to Upgrade?

To: David S. who wrote (1172)	11/21/1998 11:49:00 PM
From: Tom Genna	Read Replies (1) \| Respond to of 1510

CD4 cells may hold the key. I share with the thread some reports on the significance of CD4 cell proliferation. The following paragraph is from Reuters Health on the importance of CD4 cells: High CD4 cell counts predict virologic response to HIV protease inhibitor therapy WESTPORT, Nov 20 (Reuters Health) - HIV-infected patients who have high CD4+ cell counts when they begin retroviral therapy with a protease inhibitor are more likely to achieve and maintain undetectable viral loads, according a multicenter team. Whether or not a patient is drug naive does not appear to significantly predict virologic response. In the November 12th issue of AIDS, Dr. Amanda Mocroft of the University College in London and colleagues at the University of Calgary note that factors that have been reported to be associated with virologic response include initial viral load, regimen selection, and antiretroviral treatment history. The investigators evaluated the course of 243 HIV-positive patients treated at the Southern Alberta Clinic when protease inhibitor therapy first became available. Of the 243 subjects, 180 were drug naive and 63 were drug experienced. After 24 weeks of protease inhibitor therapy, 52.8% had undetectable viral loads. Patients with lower baseline viral loads and those who received more new antiretroviral drugs were more likely to have undetectable viral loads. Within 24 weeks after the first negative viral load test, 15.5% experienced viral rebound. Dr. Mocroft's group found that "...CD4 lymphocyte count at baseline was a significant predictor of viral load becoming detectable following an undetectable viral load measurement." Treatment with the protease inhibitor indinavir was associated with a greater likelihood of achieving and maintaining undetectable viral loads. The findings illustrate the importance of regular monitoring of CD4+ cell counts. They also "...suggest that it is the number of new drugs started rather than previous treatment that is the important [predictive] factor." The following paragraph summarizes a study of existing experimental vaccine types including those of Chiron and Genetech: These all seem to be safe, and have not had a negative effect on disease progression of those who have been involved in studies so far. While their efficacy has not been spectacular, most have at least elicited new antibody responses, and some have been shown to increase lymphocyte proliferation and development of CTL responses. They have not been shown to raise levels of CD4 T cells or lower levels of HIV in patients, but phase III studies are underway. Finally I quote the Immune Response report of its Thailand study: At 60 weeks of follow-up after treatment with REMUNE, subjects had a significant increase in CD4 cell count (p0.0001), CD4 cell percentage (p0.0001), CD8 percentage (p0.0001)and body weight (p0.0001) compared to pretreatment levels. A decrease in viral load was observed in 14 individuals with detectable viral load at baseline (p=0.04). Furthermore, 23 of 30 (77%) subjects developed HIV-specific immune responses. Does anyone think this is significant?