The effect of thalidomide on the pathogenesis of human immunodeficiency virus type 1 and M. tuberculosis infection

Jeffrey D. Klausner, Sanit Makonkawkeyoon, Pasakorn Akarasewi, Koh Nakata, Watchara Kasinrerk, Laura Corral, Robin L. Dewar, H. Clifford Lane, Victoria H. Freedman, Gilla Kaplan

Research output: Contribution to journalArticle

163 Citations (Scopus)

Abstract

Tumor necrosis factor alpha (TNF-α), a cytokine produced during the host defense against infection, is associated with fevers, weakness, and progressive weight loss. Thalidomide inhibits the synthesis of TNF-α both in vitro and in vivo and may have clinical usefulness. We therefore initiated a pilot study of thalidomide treatment in patients with human immunodeficiency virus type 1 (HIV-1)-associated wasting with or without concomitant infection with tuberculosis. Thirty-nine patients were randomly allocated to treatment with either thalidomide or placebo in a double-blind manner for 21 days. Thirty-two patients completed the study. In patients with concomitant HIV-1 and tuberculosis infections, thalidomide therapy was associated with a reduction in both plasma TNF-α levels and HIV-1 levels. No significant reduction in either TNF-α or HIV-1 levels was observed in patients with HIV- 1 infection only. During the study period, patients receiving thalidomide treatment (n = 16) showed a significant weight gain (mean ± SEM: 6.5 ± 1.2%; p < 0.02) relative to placebo-treated patients (n = 16). Patients with simultaneous HIV-1 and tuberculosis infections experienced a higher mean weight gain during thalidomide treatment than the group of patients with HIV- 1 infection only. The results of this pilot study suggest that thalidomide may have a clinical role in enhancing weight gain and possibly reducing TNF- α and HIV-1 levels in patients with HIV-1 and concomitant mycobacterial infections.

Original languageEnglish (US)
Pages (from-to)247-257
Number of pages11
JournalJournal of Acquired Immune Deficiency Syndromes and Human Retrovirology
Volume11
Issue number3
StatePublished - 1996
Externally publishedYes

Fingerprint

Thalidomide
HIV-1
Tuberculosis
Infection
Tumor Necrosis Factor-alpha
Weight Gain
HIV Infections
Placebos
Therapeutics
Weight Loss
Fever
Cytokines

Keywords

  • Human immunodeficiency syndrome type 1
  • Thalidomide
  • Tuberculosis
  • Tumor necrosis factor alpha (TNF-α)
  • Wasting

ASJC Scopus subject areas

  • Immunology and Allergy
  • Immunology
  • Virology

Cite this

Klausner, J. D., Makonkawkeyoon, S., Akarasewi, P., Nakata, K., Kasinrerk, W., Corral, L., ... Kaplan, G. (1996). The effect of thalidomide on the pathogenesis of human immunodeficiency virus type 1 and M. tuberculosis infection. Journal of Acquired Immune Deficiency Syndromes and Human Retrovirology, 11(3), 247-257.

The effect of thalidomide on the pathogenesis of human immunodeficiency virus type 1 and M. tuberculosis infection. / Klausner, Jeffrey D.; Makonkawkeyoon, Sanit; Akarasewi, Pasakorn; Nakata, Koh; Kasinrerk, Watchara; Corral, Laura; Dewar, Robin L.; Clifford Lane, H.; Freedman, Victoria H.; Kaplan, Gilla.

In: Journal of Acquired Immune Deficiency Syndromes and Human Retrovirology, Vol. 11, No. 3, 1996, p. 247-257.

Research output: Contribution to journalArticle

Klausner, JD, Makonkawkeyoon, S, Akarasewi, P, Nakata, K, Kasinrerk, W, Corral, L, Dewar, RL, Clifford Lane, H, Freedman, VH & Kaplan, G 1996, 'The effect of thalidomide on the pathogenesis of human immunodeficiency virus type 1 and M. tuberculosis infection', Journal of Acquired Immune Deficiency Syndromes and Human Retrovirology, vol. 11, no. 3, pp. 247-257.
Klausner, Jeffrey D. ; Makonkawkeyoon, Sanit ; Akarasewi, Pasakorn ; Nakata, Koh ; Kasinrerk, Watchara ; Corral, Laura ; Dewar, Robin L. ; Clifford Lane, H. ; Freedman, Victoria H. ; Kaplan, Gilla. / The effect of thalidomide on the pathogenesis of human immunodeficiency virus type 1 and M. tuberculosis infection. In: Journal of Acquired Immune Deficiency Syndromes and Human Retrovirology. 1996 ; Vol. 11, No. 3. pp. 247-257.
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