Effects of long-term zidovudine treatment on cell-mediated immune response and lymphokine production

Long-term treatment with zidovudine (ZVD, also known as AZT) can lower the risk of developing opportunistic infections and reduce the death rate of patients with AIDS. (Opportunistic infections affect patients with impaired immune function; they often signal the development of AIDS and are a common cause of death.) However, long-term treatment with ZVD can also lead to the development of toxic side effects, including adverse effects on bone marrow cells that develop and mature to red and white blood cells, including lymphocytes, which are involved in the immune response. The effects of long-term treatment with ZVD on the growth and multiplication of immune cells and the production of lymphokines were analyzed in 15 patients with AIDS who had opportunistic infections. (Lymphokines are produced by lymphocytes and are important in immune reactions.) Lymphocytes were obtained from the patients prior to treatment with ZVD, and again after three and six months of treatment. The cells were treated with various agents, called mitogens, that induce growth and multiplication of lymphocytes; the production of lymphokines was then analyzed. The growth response of lymphocytes did not change significantly after treatment with mitogens. The production of the lymphokine interleukin-2 increased after treatment, while the production of two types of another lymphokine, gamma-interferon and alpha-interferon, decreased significantly. These findings suggest that treatment with ZVD did not cause adverse effects on the proliferation of lymphocytes, or on the production of interleukin-2, but did affect the production of gamma- and alpha-interferon. This could negatively affect the immune response of patients with AIDS. (Consumer Summary produced by Reliance Medical Information, Inc.)