Cyclosporin A provides no sustained immunologic benefit to persons with chronic HIV-1 infection starting suppressive antiretroviral therapy: results of a randomized, controlled trial of the AIDS Clinical Trials Group A5138.

Abstract

BACKGROUND Although the determinants of immune deficiency and immune restoration in chronic human immunodeficiency virus (HIV)-1 infection are not well understood, immune activation has been proposed as being central to the pathogenesis of HIV. METHODS A randomized, controlled trial of cyclosporin A treatment for 2 weeks was performed in persons with chronic HIV-1 infection who were beginning a standardized antiretroviral therapy (ART) regimen. RESULTS Treatment with cyclosporin A provided only a marginal and transient enhancement in circulating T cell restoration that was largely restricted to cells expressing the CCR7 chemokine receptor and that did not persist beyond 2 weeks. CONCLUSIONS Cyclosporin A coadministered for 2 weeks with ART provided no sustained immunologic benefit to persons with chronic HIV-1 infection. If immune activation drives progressive immune deficiency in chronic HIV-1 infection, these activation pathways may not be sensitive to cyclosporin.

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@article{Lederman2006CyclosporinAP, title={Cyclosporin A provides no sustained immunologic benefit to persons with chronic HIV-1 infection starting suppressive antiretroviral therapy: results of a randomized, controlled trial of the AIDS Clinical Trials Group A5138.}, author={Michael M. Lederman and Laura M. Smeaton and Kim Y Smith and Benigno Rodr{\'i}guez and Minya Pu and Hong-ying Wang and Anne D Sevin and Pablo Tebas and Scott F. Sieg and Kathy Medvik and David M Margolis and Richard Pollard and Hildegund C. J. Ertl and Hern{\'a}n Valdez}, journal={The Journal of infectious diseases}, year={2006}, volume={194 12}, pages={1677-85} }