Intravenous immune globulin in symptomatic paediatric human immunodeficiency virus infection

Schaad, Urs B.; Gianella‐Borradori, Athos; Perret, Beat A.; Imbach, Paul; Morell, A.

doi:10.1007/bf00442700

Cited by 31 publications

(12 citation statements)

References 13 publications

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“…In symptomatic HIV-infected children, the prophylactic use of i.v. immunoglobulin for the prevention of bacterial infections was safe and was suggested as standard therapy (1,55). In addition, MAbs 2G12 and 2F5 have been infused safely into HIV-infected adults in a phase I clinical trial (H. Katinger and G. Stiegler, unpublished observations).…”

Section: Discussionmentioning

confidence: 99%

Postnatal Passive Immunization of Neonatal Macaques with a Triple Combination of Human Monoclonal Antibodies against Oral Simian-Human Immunodeficiency Virus Challenge

Hofmann‐Lehmann

Vlasak

Rasmussen

et al. 2001

J Virol

154

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To develop prophylaxis against mother-to-child human immunodeficiency virus (HIV) transmission, we established a simian-human immunodeficiency virus (SHIV) infection model in neonatal macaques. In the present study, we used this MAb combination only postnatally, thereby significantly reducing the quantity of antibodies necessary and rendering their potential use in humans more practical. We protected two neonates with this regimen against oral SHIV-vpu ؉ challenge, while four untreated control animals became persistently infected. Thus, synergistic MAbs protect when used as immunoprophylaxis without the prenatal dose. We then determined in vitro the optimal MAb combination against the more pathogenic SHIV89.6P, a chimeric virus encoding env of the primary HIV89.6. Remarkably, the most potent combination included IgG1b12, which alone does not neutralize SHIV89.6P. We administered the combination of MAbs IgG1b12, 2F5, and 2G12 postnatally to four neonates. One of the four infants remained uninfected after oral challenge with SHIV89.6P, and two infants had no or a delayed CD4 ؉ T-cell decline. In contrast, all control animals had dramatic drops in their CD4 ؉ T cells by 2 weeks postexposure. We conclude that our triple MAb combination partially protected against mucosal challenge with the highly pathogenic SHIV89.6P. Thus, combination immunoprophylaxis with passively administered synergistic human MAbs may play a role in the clinical prevention of mother-to-infant transmission of HIV type 1.

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Section: Discussionmentioning

confidence: 99%

Postnatal Passive Immunization of Neonatal Macaques with a Triple Combination of Human Monoclonal Antibodies against Oral Simian-Human Immunodeficiency Virus Challenge

Hofmann‐Lehmann

Vlasak

Rasmussen

et al. 2001

J Virol

154

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“…A clinical amelioration was reported by other authors as well [14,[42][43][44][45], although trials on adults are rare [46][47][48]59], All but two studies were uncontrolled; one study was announced as 'randomized', but did not provide any in formation about the control group [59], the other was con ducted on four groups, showing a decrease in opportunistic infections in the treatment group [48].…”

Section: Discussionmentioning

confidence: 70%

“…In HIV-l-infected children, high-dose intravenous im munoglobulins (HD-IVIG) are known as an effective therapeutic principle in reducing the frequency of episodes of bacterial infections, fever and diarrhea [14,15,[42][43][44][45]. In adults, only few studies were done [44,[46][47][48] showing encouraging results on the clinical course but without thor ough evidence of restitution of cellular immunity.…”

Section: Introductionmentioning

confidence: 99%

High-Dose Intravenous Immunoglobulins in HIV-l-Infected Adults with AIDS-Related Complex and Walter-Reed 5

Schrappe-Bächer¹,

Rasokat²,

Bauer³

et al. 1990

Vox Sanguinis

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The influence of high-dose intravenous immunoglobulins (HD-IVIG) on the clinical status and T4 cell count of adults with AIDS-related complex (ARC) and Walter-Reed 5 (WR5) was evaluated in a randomized double-blind longitudinal study. Inclusion criteria were: (1) T4 cells <400/µl and (2a) oral thrush or cutaneous anergy or (2b) two clinical ARC criteria (fever, diarrhea, weight loss, fatigue, night sweats). Thirty patients [28 males, 2 females, median age 41 (24-64) years] with ARC (n = 8), WR5 (n = 12) and both (n = 10) were stratified according to their T4 cell count (≥ vs. <300/µl). Fifteen patients received 0.4g/kg body weight IVIG and 15 placebo (albumin 0.03%) every other week for 26 weeks with follow-up for another 26 weeks. The clinical status was defined as a score consisting of fever, diarrhea, night sweats, fatigue, weight loss, oral candidiasis and mucosal or cutaneous herpes simplex. Clinical examination and routine laboratory assessments were performed before initiation of the study and before each administration, lymphocyte phenotyping every 4 weeks and cutaneous reaction, serology and lymphocyte stimulation every 12 weeks. Both groups were comparable in initial clinical symptoms and laboratory values. Seven patients developed AIDS (treatment group: 3, placebo group: 4), 1 patient died by homicide. After 26 weeks, the clinical score (particularly fatigue and fever) was significantly improved in the treatment group, while the T4 cell count and other clinical and immunological parameters remained unaltered. This limited effect was still evident at termination of the study after 52 weeks. In conclusion, HD-IVIG can improve the clinical status of patients with advanced HIV-1 infection without obviously correcting the underlying impaired cellular immunity. The substitution of intact antibodies in the state of functional hypogammaglobulinemia is suggested as possible therapeutic mechanism.

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“…While no prospective randomized controlled studies have been reported to date, several crossover studies with HIV-infected children have been described (13,25). One particularly interesting prospective study was conducted in Scotland (13).…”

Section: New Uses Of Igiv For Prophylaxismentioning

confidence: 99%

Newer uses of intravenous immunoglobulins as anti-infective agents

Pennington

1990

Antimicrob Agents Chemother

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Intravenous immune globulin in symptomatic paediatric human immunodeficiency virus infection

Cited by 31 publications

References 13 publications

Postnatal Passive Immunization of Neonatal Macaques with a Triple Combination of Human Monoclonal Antibodies against Oral Simian-Human Immunodeficiency Virus Challenge

Postnatal Passive Immunization of Neonatal Macaques with a Triple Combination of Human Monoclonal Antibodies against Oral Simian-Human Immunodeficiency Virus Challenge

High-Dose Intravenous Immunoglobulins in HIV-l-Infected Adults with AIDS-Related Complex and Walter-Reed 5

Newer uses of intravenous immunoglobulins as anti-infective agents

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