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- W2138530621 abstract "Inflammatory diseases of the skin are common in AIDS, yet little is known regarding the safety of anti-inflammatory therapies in AIDS patients. This study examined the clinical effects, immunology, microbiology, and virology of tumor necrosis factor (TNF) blockade using etanercept (soluble TNF receptor) during initial treatment of HIV+ tuberculosis (TB). Its goal was to understand the role of TNF in HIV/TB copathogenesis. The study, a single arm trial, with key endpoints compared to historical controls, was performed in Mulago Hospital, Kampala Uganda. Subjects consisted of 16 HIV-1-infected subjects and 42 CD4-frequency-matched controls with sputum smear-positive tuberculosis and CD4 counts > 200/ml. Etanercept 25 mg, 8 doses administered subcutaneously twice weekly beginning on day 4 of standard TB therapy. Antiretroviral therapy was not administered. The main outcome measures were physical examination, chest X-rays, sputum cultures, serum neopterin, CD4+ T cell count, plasma log10 HIV RNA copy number. Addition of etanercept to standard TB therapy resulted in a 25% increase in CD4 cells by week 4 (p=.1 compared to controls). Change in CD4 count was inversely related to change in serum neopterin, a marker of macrophage activation. There was no effect on plasma HIV RNA. Trends toward superior responses to TB treatment were evident in etanercept treated subjects with respect to body mass, performance score, number of involved lung zones, cavitary closure, and time to sputum culture conversion. Etanercept can be safely administered during initial treatment of pulmonary tuberculosis. Further studies are warranted to examine the effects of etanercept on T cell number, activation and apoptosis in AIDS and tuberculosis. I do not have any financial interests with any manufacturer or pharmaceutical company. Writing completed by primary author and poster production provided by Amgen Inc." @default.
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- W2138530621 date "2004-03-01" @default.
- W2138530621 modified "2023-10-17" @default.
- W2138530621 title "Adjunctive treatment with etanercept in HIV-1-associated tuberculosis" @default.
- W2138530621 doi "https://doi.org/10.1016/j.jaad.2003.10.365" @default.
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