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

Michael M. Lederman, Laura Smeaton, Kim Y. Smith, Benigno Rodriguez, Minya Pu, Hongying Wang, Anne Sevin, Pablo Tebas, Scott F. Sieg, Kathy Medvik, David M. Margolis, Richard B Pollard, Hildegund C J Ertl, Hernan Valdez

Research output: Contribution to journalArticle

29 Citations (Scopus)

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.

Original languageEnglish (US)
Pages (from-to)1677-1685
Number of pages9
JournalJournal of Infectious Diseases
Volume194
Issue number12
DOIs
StatePublished - Dec 15 2006

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Virus Diseases
Cyclosporine
HIV-1
Acquired Immunodeficiency Syndrome
Randomized Controlled Trials
Clinical Trials
CCR7 Receptors
Chemokine Receptors
Therapeutics
HIV
T-Lymphocytes

ASJC Scopus subject areas

  • Public Health, Environmental and Occupational Health
  • Immunology

Cite this

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. / Lederman, Michael M.; Smeaton, Laura; Smith, Kim Y.; Rodriguez, Benigno; Pu, Minya; Wang, Hongying; Sevin, Anne; Tebas, Pablo; Sieg, Scott F.; Medvik, Kathy; Margolis, David M.; Pollard, Richard B; Ertl, Hildegund C J; Valdez, Hernan.

In: Journal of Infectious Diseases, Vol. 194, No. 12, 15.12.2006, p. 1677-1685.

Research output: Contribution to journalArticle

Lederman, Michael M. ; Smeaton, Laura ; Smith, Kim Y. ; Rodriguez, Benigno ; Pu, Minya ; Wang, Hongying ; Sevin, Anne ; Tebas, Pablo ; Sieg, Scott F. ; Medvik, Kathy ; Margolis, David M. ; Pollard, Richard B ; Ertl, Hildegund C J ; Valdez, Hernan. / 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. In: Journal of Infectious Diseases. 2006 ; Vol. 194, No. 12. pp. 1677-1685.
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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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AU - Tebas, Pablo

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