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CBS interview: Dr. Ho/Dr. Markowitz study of cyclosporine in HIV treatment

Mar 27, 2005

Hi, Doctor Pierone:

Thank you for your website and always excellent and supportive advice.

Since I have to go on prednisone due to bad asthma, I was reading your answer to a question about studies of immune suppressant drugs in HIV patients and the surprising initial results (like the German study you wrote about) that low doses might even slow HIV progression and immune decline. As you can imagine, I worry that the prednisone can damage the immune system in the face of HIV.

In your answer, you commented that there are no ongoing studies on the important issue whether immune suppressants can be valuable in treating HIV. I came across a CBS TV interview on their website with Dr. David Ho in which he says to the CBS interviewer toward the end of the interview that his colleague Dr. Markowitz has an ongoing study using cyclosporine in HIV treatment. Would it be possible for you to find out and clarify for us what those results have shown so far? As you pointed out, the drug companies don't do this potentially important research, so it is great that Dr. Ho's group is...any light you can help shed on the findings so far of that Ho/Markowitz study would be very helpful, especially to those of us who HAVE to take prednisone or other immune suppressants.

I also wonder why the Ho/Markowitz study chose cyclosporine rather than prednisone?.

Many thanks.

Response from Dr. Pierone

I guess that I should have said there were no ongoing studies that I was aware of using immune suppressants. Actually, there are a number of investigators interested in this topic and things are moving (at the pace of a frozen glacier). There was a very interesting study - link from another group that looked at cyclosporine in primary HIV infection which was presented at the recent Retrovirus conference in Boston. They showed that an 8 week course of cyclosporine together with HAART in primary HIV infection led to statistically significant CD4 count improvements (after HAART was stopped) compared to a control group that received HAART only. I asked the presenting author why he used cyclosporine instead of prednisone and he gave me a detailed mechanistic answer based on the basic science of early HIV-immune interactions that I could not follow. Since Dr. Ho and Markowitz are known for their work on primary HIV infection it could be possible that they are performing a similar study.

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