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EXTRACORPOREAL PHOTOPHERESIS

originally from

JOURNAL WATCH

Copyright 1988 Massachusetts Medical Society.

All rights reserved.

Electronically reproduced at DR B’S BBS

by permission from the publisher.

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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.

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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