originally from
JOURNAL WATCH
Copyright 1988 Massachusetts Medical Society.
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9/04/90
A PRELIMINARY STUDY OF EXTRACORPOREAL PHOTOPHERESIS
FOR HIV INFECTION
The combination of ultraviolet irradiation and orally
administered psoralen has been used successfully to treat psoriasis
and cutaneous lymphoma.
This combination, which can also inactivate some viruses by
cross-linking their DNA, has now been studied in preliminary fashion
in patients with AIDS-related complex.
Five HIV-infected patients with lymphadenopathy and systemic
symptoms underwent leukapheresis after taking 8-methoxypsoralen.
The leukocyte-enriched separated fraction of blood was then
exposed to ultraviolet A and returned to the patient. The procedure
was repeated twice a month for six months, and patients were
followed for an additional nine months.
Lymphadenopathy resolved in all patients, and systemic symptoms
improved in four.
Page 1
At 15 months, blood cultures for HIV had become negative in two
patients. Two completely anergic patients regained skin-test
reactivity.
The CD4:CD8 T-cell ratio stabilized or increased, and antibodies
to HIV antigens p24 and gp120 increased in all patients. There was
no apparent treatment-associated toxicity.
Given the uncontrolled and unblinded protocol, these results must
be regarded with caution. Nevertheless, the authors believe that
this therapy warrants further study. — ASB.
Bisaccia E; et al. Extracorporeal photopheresis in the
treatment of AIDS-related complex:
a pilot study.
Ann Intern Med 1990 Aug 15; 113:270-5