Synthetic Adrenal Hormone Curbs TB in AIDS Patients

By David Douglas

NEW YORK (Reuters Health) Aug 15 - Treatment with HE2000, a synthetically modified androstane adrenal hormone, reduces the incidence of TB coinfection in AIDS patients by more than 40% and also reduces the incidence of other opportunistic infections, according to US and South African investigators.

"To our knowledge," lead investigator Dr. Dwight R. Stickney told Reuters Health, "this is the first time that an immune modulator has demonstrated a benefit in reducing the incidence of opportunistic infections, such as tuberculosis, in AIDS patients."

In the July issue of Antimicrobial Agents and Chemotherapy, Dr. Stickney of Hollis-Eden Pharmaceuticals in San Diego, California, and colleagues note that HE2000 decreases inflammatory cytokines and increases circulating dendritic cells, T-NK cells and HIV-specific activated CD8 T-cells. It can clear malarial parasites and has shown efficacy in other diseases.

The researchers studied 25 AIDS patients in Cape Town; 14 of them were given daily injections of HE2000, the remaining 11 patients were given placebo. The team notes that the study took place at a time when antiretroviral drugs were not permitted in South Africa and thus could not be used.

During a median follow-up of more than 8 months in both groups, 63.4% of placebo patients developed TB compared to 21.4% of those who received HE2000.

There also was a significant cumulative reduction in opportunistic infections such as candidiasis over the study period. After adjustment, placebo patients had each accumulated a mean of 6.8 such infections compared to 3.84 in the HE2000 group.

"The ability to reduce the incidence of tuberculosis, which is a leading cause of morbidity and mortality in AIDS patients, holds the potential of developing an immune-based approach to managing the incidence of infections in this patient population," continued Dr. Stickney.

"Such an approach," he pointed out, "could prove especially beneficial in light of the growing prevalence of drug-resistant strains of tuberculosis that are no longer treatable with conventional antibiotic regimens."

Antimicrob Agents Chemother 2007;51:2639-2641.