Increases in CD4 T lymphocytes with intermittent courses of interleukin-2 in patients with human immunodeficiency virus infection

Long term therapy of HIV patients with CD4 cell counts over 200 per cubic millimeter may benefit from intermittent courses of interleukin-2. Interleukin-2 may improve some of the immunologic abnormalities. A study of 25 HIV-infected patients who received continuous infusions of interleukin-2 for five days every eight weeks over seven to 25 months found that interleukin-2 therapy induced a 50% increase in the number of CD4 cells in six of 10 patients with baseline CD4 cell counts over 200. The most benefit was seen in patients without a severely deficient immune system and with a low viral burden. The increase in CD4 cells lasted for up to eight months in some patients and could be reinduced by additional interleukin-2 infusions. Interleukin-2 therapy was associated with a decline in the numbers CD8 cells that expressed HLA-DR. An increase in CD8 cells expressing HLA-DR may indicate a poor outcome. Therapy increased the number of cells with the interleukin-2 receptor, which may have contributed to the sustenance of the increase in CD4 cells. An antiretroviral regimen may be needed during interleukin-2 therapy.