Effects of tapering doses of oral prednisone on viral load among HIV- infected patients with unexplained weight loss

Academic Article

Abstract

  • In an exploratory study of virologic and immunomodulatory effects of corticosteroid therapy for wasting syndrome, four HIV-infected adults with recent unexplained weight loss were given tapering doses of prednisone over a 2-month period. Serum neopterin and TNF receptor II levels decreased from baseline after 7 days. An antiretroviral effect was observed initially, peaking on days 14-21 (mean change in HIV-1 branched chain DNA assay on day 21 of -0.52 log10; mean change, from baseline to nadir for each individual, of -0.63 log10); subsequent bDNA levels returned toward baseline as prednisone was tapered. No patient lost weight and there was a mean weight gain of 3.5 kg. Anecdotal reports of corticosteroid benefits in the wasting syndrome may result in part from decreased T cell activation leading to decreased HIV replication, an effect that may be self-limited or that may occur only at higher prednisone doses. Studies involving more targeted immunomodulatory agents for wasting syndrome are warranted.
  • Author List

  • Michael Kilby J; Tabereaux PB; Mulanovich V; Shaw GM; Patterson Bucy R; Saag MS
  • Start Page

  • 1533
  • End Page

  • 1537
  • Volume

  • 13
  • Issue

  • 17