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Titre du document / Document title

Acetyl salicylic acid (ASPIRIN) increases the CD4+ T lymphocytes and suppresses TNF-a in HIV-I infected patients: Results of a 12 month, three-arm, placebo-controlled pilot study

Auteur(s) / Author(s)

ELOPY NIMELE SIBANDA (1) ; STANZUK Grazyna A. (2 3) ; THOMSEN Marianne (4) ;

Affiliation(s) du ou des auteurs / Author(s) Affiliation(s)

(1) Department of Immunology, College of Medicine, University of Zimbabwe, Box A 178, Avondale, Harare, ZIMBABWE
(2) Department of obstetrics and Gynaecology, College of Medicine, University of Zimbabwe, Box A 178, Avondale, Harare, ZIMBABWE
(3) Division of International Heakh (ICHAR), Karolinska Institutet Stockholm, SUEDE
(4) Total Control of the Epidemic (TCE) Program of Humana, Murgwi Estates Shamva, ZIMBABWE

Résumé / Abstract

The aim of this pilot study was to investigate the use of aspirin in the management of HIV disease. It is three-arm, placebo controlled 6-month crossover study with a 12 months patient follow-up. Anti-retroviral naive HIV-1 infected patients with a CD4+ T lymphocyte count greater than 150 cells/ml were enrolled and randomized into 3 groups, which received (a) the placebo, (b) Acetyl-salicylic acid (aspirin) 300 mg four times a day and (c) chloroquine150 mg thrice a day. Thirty-one of 52 HIV+ volunteers fuelled the enrolment criteria. The body mass, CD4+/CD8+ counts, HIV viral load, p24 antigen levels and complete blood counts (CBC) were measured at baseline and three-monthly. Plasma levels of the cytokines IL-2, IL-4, IL-6 and TNF-a were measured at baseline and after 6 months. Twenty-four participants had complete paired CD4 and viral load data, of these 7 were in the placebo arm, 10 in the aspirin/chloroquine arm and 7 in the aspirin arm. There was an increase (p<0.05) in both body mass and haemoglobin levels. In the placebo arm, the median CD4+ T lymphocyte count decreased from a baseline of 258 to 216 cells (16%) [p=0.038] in 24 weeks but doubled to 471 (46%) [p=0.075] a mere 12 weeks after the patients were crossed over to the aspirin arm. In the aspirin treated group, the CD4 count increased by 23.3% from a mean baseline of 363 after 24 weeks [p=0.0]5] to 665 after 36 weeks [p=0.078 by the Wilcoxon rank test] followed by a statistically insignificant drop to 495 after 12 months. During the 52-weeks of aspirin treatment, the overall mean CD4 count increased from 363 to 495 [p=0.03]. In the aspirin/chloroquine arm the median CD4 count remained unchanged being 394 (95% CI=294;519) at baseline and 394 (95%CI=275;563) after 24 weeks treatment. These values increased by 23% to 508 (p=0.0137) 12 weeks only after switching to an aspirin only regimen. All the patients who were p24 antigen positive at enrolment became p24Ag negative after 6 months in the aspirin arm. There was an increase in p24 antigen levels (p=0.05) in the chloroquine arm. In the placebo arm, the number of p24 antigenaemic patients increased from 29% at enrolment to 71% after 6 months. The viral load (VL) also increased in the placebo but not the aspirin and the aspirin+chloroquine arms. There was an inverse relation between plasma TNF-a levels and the CD4 count in all cases. In the placebo arm, TNF-a increased in the first 24 weeks and decreased after cross-over. In the aspirin arm TNF-a decreased but remained unchanged in the aspirin/chloroquine group. IL-6 decreased significantly in the chloroquine arm. IL-2 and IL-4 levels did not vary significantly between the groups. The data presented in this pilot study show that, the administration of aspirin to HIV-1 infected individuals resulted in a significant increase in T lymphocytes numbers, decreases in p24 and in TNF-α. We are persuaded that there is merit in further investigating the mechanisms through which this combination increased the CD4+ cell count and defining whether this agent has any role in the HIV management algorithms.

Source / Source

AIDS vaccines and related topics 2004
2004  , pp. 179-190[Note(s) :  [239 p.]] [Document : 12 p.] (38 ref.) ISBN 81-7736-112-0 ;  Illustration : Illustration ;

Langue / Language

Anglais

Editeur / Publisher

Research signpost, Trivandrum, INDE  (2004) (Monographie)

Mots-clés anglais / English Keywords

Immunopathology

;

Immune deficiency

;

Infection

;

Viral disease

;

Human

;

Tumor necrosis factor

;

T-Lymphocyte

;

Biological activity

;

Acetylsalicylic acid

;

AIDS

;

Mots-clés français / French Keywords

Immunopathologie

;

Immunodéficit

;

Infection

;

Virose

;

Antigène CD4

;

Homme

;

Facteur nécrose tumorale

;

Lymphocyte T

;

Activité biologique

;

Acétylsalicylique acide

;

SIDA

;

Mots-clés espagnols / Spanish Keywords

Inmunopatología

;

Inmunodeficiencia

;

Infección

;

Virosis

;

Hombre

;

Factor necrosis tumoral

;

Linfocito T

;

Actividad biológica

;

Acetilsalicilico ácido

;

SIDA

;

Localisation / Location

INIST-CNRS, Cote INIST : L 29504, 35400012436748.0140

Nº notice refdoc (ud4) : 16464616



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