Effect of Intermittent Interleukin-2 Therapy on Plasma and Tissue Human Immunodeficiency Virus Levels and Quasi-Species Expression [Kovacs JA, et al. JID 2000;182:1063]: The authors report their experience with 11 patients with HIV infection and CD4 cell counts >200/mm³ treated with IL-2 starting with doses of 18 million IU/day for five days repeated monthly for one year. Viral load measurements were made daily for ten days after each cycle. Six of the 11 patients showed a viral load increase >0.5 log₁₀ during at least one cycle, and two had such an increase in over half of all cycles. Three of the remaining five patients had decreases. There were no changes in tonsil levels of HIV. Analysis of a separate cohort for quasi-species showed that IL-2 generally induced the pre-therapy strains. The authors conclude that intermittent IL-2 does not cause a sustained increase in either plasma or tissue levels of HIV, and does not cause expression of previously silent quasi species.
Comment: The rationale of this study is based on the concern that IL-2 could result in sustained HIV viremia. In fact, this was viewed as a potential benefit for eliminating latent virus. The present study shows that IL-2 may induce increased levels of HIV, but this is not seen in all patients and appears to be transient. posted 10/19/2000