Allergen immunotherapy in a patient with human immunodeficiency virus: effect on T-cell activation and viral replication

Randhawa, Inderpal; Junaid, Imran; Klaustermeyer, William B.

doi:10.1016/s1081-1206(10)60767-3

Cited by 21 publications

(10 citation statements)

References 10 publications

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“…Theoretically, immunomodulation during AIT could influence the activation of infected CD4 + cells. However, it has been suggested that AIT may be performed in pollen‐ and mite‐allergic patients with ‘early to middle stage’ HIV disease, no acquired immune deficiency syndrome (AIDS)‐associated pathology, a CD4 + count ≥400 cells/μl, and an undetectable viral load . We did not identify any controlled studies of AIT in HIV‐infected patients. We identified case studies of patients treated with AIT with airborne allergens; all were in patients already under highly active antiretroviral therapy (HAART) before starting AIT . In only one of the cases, in a patient with undetectable viral load during the first 6 weeks of AIT, the virus was detected on the 16th week of AIT with an increase in CD4 + cells.…”

Section: Resultsmentioning

confidence: 99%

Clinical contraindications to allergen immunotherapy: an EAACI position paper

Pitsios

Demoly

Bilò

et al. 2015

Allergy

206

177

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Clinical indications for allergen immunotherapy (AIT) in respiratory and Hymenoptera venom allergy are well established; however, clinical contraindications to AIT are not always well documented. There are some discrepancies when classifying clinical contraindications for different forms of AIT as 'absolute' or 'relative'. EAACI Task Force on 'Contraindications to AIT' was created to evaluate and review current literature on clinical contraindications, and to update recommendations for both sublingual and subcutaneous AIT for respiratory and venom immunotherapy. An extensive review of the literature was performed on the use of AIT in asthma, autoimmune disorders, malignant neoplasias, cardiovascular diseases, acquired immunodeficiencies and other chronic diseases (including mental disorders), in patients treated with b-blockers, ACE inhibitors or monoamine oxidase inhibitors, in children under 5 years of age, during pregnancy and in patients with poor compliance. Each topic was addressed by the following three questions: (1) Are there any negative effects of AIT on this concomitant condition/disease? (2) Are more frequent or more severe AIT-related side-effects expected? and (3) Is AIT expected to be less efficacious? The evidence, for the evaluation of these clinical conditions as contraindications, was limited, and most of the conclusions were based on case reports. Based on an extended literature research, recommendations for each medical condition assessed are provided. The final decision on the administration of AIT should be based on individual evaluation of any medical condition and a risk/benefit assessment for each patient.Allergen immunotherapy (AIT) has been used worldwide for over a century and is currently the only causative therapy for the treatment of respiratory allergies (1-3), and Hymenoptera venom allergy (4). Although clinical indications for AIT are specific and widely accepted, clinical contraindications to AIT differ between various guidelines (1, 2, 4, 5).Allergy 70 (2015) 897-909

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Section: Resultsmentioning

confidence: 99%

Clinical contraindications to allergen immunotherapy: an EAACI position paper

Pitsios

Demoly

Bilò

et al. 2015

Allergy

206

177

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“…Cases of allergen immunotherapy in patients with HIV controlled with highly active antiretroviral therapy are reported. 201,202 In 1 case report, allergen immunotherapy appeared to induce a transient T-cell proliferation and modest increase in RNA viral load, which resolved with highly active antiretroviral therapy. 201 In another patient a 3.5-year course of immunotherapy for tree pollen-induced allergic rhinitis was successful in reducing the reported visual analog scale for subjective symptoms and medication use by almost 90%.…”

Section: Immunotherapy In Patients With Immunodeficiency and Autoimmumentioning

confidence: 99%

“…201,202 In 1 case report, allergen immunotherapy appeared to induce a transient T-cell proliferation and modest increase in RNA viral load, which resolved with highly active antiretroviral therapy. 201 In another patient a 3.5-year course of immunotherapy for tree pollen-induced allergic rhinitis was successful in reducing the reported visual analog scale for subjective symptoms and medication use by almost 90%. 202 During therapy, his CD4 cell count remained greater than 350 cells/mL, and his HIV RNA level remained less than 50 copies/mL.…”

Section: Immunotherapy In Patients With Immunodeficiency and Autoimmumentioning

confidence: 99%

Allergen immunotherapy: A practice parameter third update

Cox

Nelson

Lockey

et al. 2011

Journal of Allergy and Clinical Immunology

1,005

1,054

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“…There are also some case reports in the literature that would seem to indicate that specific AIT is safe in HIV‐positive patients, at least in the early stages of the disease or in patients on antiretroviral therapy with low VL and discrete CD4 count . A review article suggests guidelines for the allergy treatment in HIV‐positive patients with early to middle HIV disease with a CD4 count of 400 or more cells/mm 3 with no history of AIDS‐associated diseases and no evidence of plasma viremia.…”

Section: Discussionmentioning

confidence: 99%

Sublingual allergen immunotherapy in HIV‐positive patients

Iemoli

Borgonovo

Fusi

et al. 2015

Allergy

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HIV infection is a relative contraindication for allergic immunotherapy (AIT). In the last decade, highly active antiretroviral therapy (HAART) has improved the immune function and life expectancy in HIV-infected patients whose respiratory allergic incidence is similar to the general population. We evaluated the safety and clinical effectiveness of sublingual immunotherapy in a group of grass pollen-allergic HAART-treated HIV-positive patients. Thirteen patients received sublingual immunotherapy (SLIT) tablet (Oralair, Stallergenes©) and symptomatic therapy and were compared with nine patients receiving symptomatic therapy alone. Clinical benefits were evaluated by the analysis of total combined score (TCS), sum of symptom-medication score, and a quality of life (QoL) questionnaire. HIV viral load and peripheral TCD4 lymphocytes were analyzed at the beginning and at the end of the study. Clinical efficacy data showed a significant improvement in SLIT-treated patients compared to controls (TCS: P = 0.0001; QoL: P = 0.03). We did not observe any significant alteration of TCD4 cell counts and viral load (VL) in both groups. Our preliminary data showed that SLIT therapy in viro-immunological controlled HAART treated HIV positive patients was efficacious, safe and well tolerated.

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Allergen immunotherapy in a patient with human immunodeficiency virus: effect on T-cell activation and viral replication

Cited by 21 publications

References 10 publications

Clinical contraindications to allergen immunotherapy: an EAACI position paper

Clinical contraindications to allergen immunotherapy: an EAACI position paper

Allergen immunotherapy: A practice parameter third update

Sublingual allergen immunotherapy in HIV‐positive patients

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