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IL2 Low Dose

Aug 19, 2001

Dear Doc, I want to discuss with my Doc,the possibility of doing some low dose IL2. How much is low dose? How often and how long? Have you ever heard of depression being a side effect of low dose or is that only at high dose? Keep up your good work, your doing a great job. Toronto

Response from Dr. Cohen

IL-2 is one of those meds with lots of info, and lots of controversy.

One controversy is whether it does something we need to do with medication other than antivirals alone - and that explains why there are very large international studies going on randomizing people to treatment either with or without IL2. And one of these years we will have an answer. Until then we have controversy. And it is still unclear what IL2 does for us - other than changing the CD4 counts we measure.

Another uncertainty is the dose. There are side effects at most doses - although far more toxicity as we increase the dose. There is no clear definition of what is a "low dose" as it depends on what you are trying to accomplish. If the use if the usual one, meaning you are going for a boost in the CD4 counts, the most proven way to do this is a dose of about 3 to 5 million units of IL-2 given once or twice a day for five days per week, and this five day cycle is done about every 2 months or so. This approach has resulted in increasing the CD4 counts, and has done so without increasing the viral load. But yes depression and other side effects can be seen even at this dose. Not in everyone of course, but can occur in some. Now there are even lower doses that have been studied and these are even more controversial in that there are fewer data to support the use of lower doses, although research continues on this.

Hope that helps. Thanks for the compliment, by the way....

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