The emerging role of thalidomide therapy in HIV-infected patients

Thalidomide is a potent immune response-modifying drug; among its known modes of action is the inhibition of the inflammatory cytokine tumor necrosis factor-alpha (TNF-alpha, or 'cachectin'). Clinical studies have shown that thalidomide may ameliorate AIDS-associated weight loss. In addition, clinical evidence indicates a role for thalidomide in the treatment of HIV-associated aphthous ulceration. However, toxicities from thalidomide therapy are more common in patients infected with HIV than in uninfected persons, and patients must be monitored carefully to avoid the drug's well-known teratogenic effects.