A RANDOMIZED, DOUBLE-BLIND, PHASE-I/II TRIAL OF TUMOR-NECROSIS-FACTOR AND INTERFERON-GAMMA FOR TREATMENT OF AIDS-RELATED COMPLEX (PROTOCOL-025 FROM THE AIDS CLINICAL-TRIALS GROUP)

To determine safety and efficacy of tumor necrosis factor (TNF) and interferon-gamma (IFN-gamma) in the treatment of patients with acquired immunodeficiency syndrome (AIDS)-related complex, a randomized, double-blind study was conducted. Twenty-five patients with AIDS-related complex and CD4 lymphocytes less-than-or-equal-to 500 x 10(6)/L attended an AIDS Clinical Trials Unit of a tertiary referral center. Patients were administered tumor necrosis factor (TNF) (10-mu-g/m2) or IFN-gamma (10-mu-g/m2), or both intramuscularly three times weekly for 16 weeks. Side effects from all three preparations included fever, constitutional symptoms, and local reactions. No significant hematologic, hepatic, renal, or coagulation abnormalities were observed. CD4 lymphocyte counts, beta-2-microglobulin, p24 antigen levels, and anti-p24 antibody did not change significantly during therapy. Similarly, no significant change was noted in rates of HIV isolation from peripheral blood mononuclear cells or plasma. TNF and IFN-gamma were tolerable after premedication with acetaminophen; however, no significant change in markers of human immunodeficiency virus infection was demonstrated. These cytokines alone do not appear to be of benefit, nor do they appear to hasten the progression of HIV infection.