Forum for Science, Industry and Business

Sponsored by:     3M 
Search our Site:

 

Prednisolone ineffective against HIV-associated pleural tuberculosis

06.08.2004


Nor can it be recommended for those with pleural tuberculosis who are not co-infected with HIV

Prednisolone, a glucocorticoid that is sometimes added to anti-tuberculosis drug regimens, should not be used to treat patients with pleural tuberculosis and HIV infection, nor can it be recommended for those with pleural tuberculosis who are not co-infected with HIV, according to a study in the August 15 issue of The Journal of Infectious Diseases, now available online.

Alison M. Elliott, of the London School of Hygiene and Tropical Medicine, and colleagues from Uganda, England, and the United States conducted a double-blind, placebo-controlled study of prednisolone in 197 patients with HIV-1-associated pleural tuberculosis. The expectation was that the drug might retard HIV progression and thus prolong survival. In fact, it had no effect on survival but did increase the risk of the AIDS-related cancer Kaposi’s sarcoma.



The investigators noted that, although prednisolone suppresses the immune system’s response to tuberculosis when used alone, its use is associated with improved survival when taken with anti-tuberculosis drugs--notably, in pericardial tuberculosis. Previous studies had shown that active tuberculosis is associated with a high degree of immune activation, which also plays a large role in promoting HIV replication. The investigators therefore hypothesized that adding prednisolone to a regimen of anti-tuberculosis drugs might inhibit viral replication, retard progression of HIV disease, and improve long-term survival. As prednisolone is relatively inexpensive and widely available, this would have been of value in fighting tuberculosis and HIV co-infection, especially in resource-poor regions of the world as sub-Saharan Africa.

The authors performed their study at the National Tuberculosis Treatment Centre in Kampala, Uganda between November 1998 and January 2002. Of the 197 patients studied, 99 were given prednisolone and 98 a placebo, along with standard tuberculosis treatment.

The patients receiving prednisolone did see improvement in the principal signs and symptoms of pleural tuberculosis, especially anorexia, weight loss, and cough. Although prednisolone use was not associated with such HIV-associated opportunistic diseases as cryptococcal meningitis, esophageal or oral candidiasis, herpes zoster, or oral or genital herpes simplex infection, it did significantly increase the risk of Kaposi’s sarcoma, six cases of which were observed, and only in the prednisolone group. This finding mirrored a previous Zambian study in which Kaposi’s sarcoma also occurred only in a group given prednisolone to treat pleural tuberculosis. An opportunistic disease associated with human herpes virus 8 infection, Kaposi’s sarcoma is often difficult to treat and may be fatal.

Given an increased risk of Kaposi’s sarcoma, no improvement in survival, and no reported long-term benefits of glucocorticoids in patients with pleural tuberculosis who were not HIV-infected, the authors concluded that pleural tuberculosis should not be treated with prednisolone, regardless of HIV status. This recommendation, they noted, does not extend to other uses of prednisolone, such as treatment of pericardial tuberculosis or Pneumocystis carinii pneumonia, for which the drug can prolong or save lives, regardless of a patient’s HIV status. They warned, however, that "prednisolone should be used with caution in situations where no beneficial effect on immediate survival can be expected."

Jeff Minerd | EurekAlert!
Further information:
http://www.idsociety.org

More articles from Health and Medicine:

nachricht Laser activated gold pyramids could deliver drugs, DNA into cells without harm
24.03.2017 | Harvard John A. Paulson School of Engineering and Applied Sciences

nachricht What does congenital Zika syndrome look like?
24.03.2017 | University of California - San Diego

All articles from Health and Medicine >>>

The most recent press releases about innovation >>>

Die letzten 5 Focus-News des innovations-reports im Überblick:

Im Focus: Giant Magnetic Fields in the Universe

Astronomers from Bonn and Tautenburg in Thuringia (Germany) used the 100-m radio telescope at Effelsberg to observe several galaxy clusters. At the edges of these large accumulations of dark matter, stellar systems (galaxies), hot gas, and charged particles, they found magnetic fields that are exceptionally ordered over distances of many million light years. This makes them the most extended magnetic fields in the universe known so far.

The results will be published on March 22 in the journal „Astronomy & Astrophysics“.

Galaxy clusters are the largest gravitationally bound structures in the universe. With a typical extent of about 10 million light years, i.e. 100 times the...

Im Focus: Tracing down linear ubiquitination

Researchers at the Goethe University Frankfurt, together with partners from the University of Tübingen in Germany and Queen Mary University as well as Francis Crick Institute from London (UK) have developed a novel technology to decipher the secret ubiquitin code.

Ubiquitin is a small protein that can be linked to other cellular proteins, thereby controlling and modulating their functions. The attachment occurs in many...

Im Focus: Perovskite edges can be tuned for optoelectronic performance

Layered 2D material improves efficiency for solar cells and LEDs

In the eternal search for next generation high-efficiency solar cells and LEDs, scientists at Los Alamos National Laboratory and their partners are creating...

Im Focus: Polymer-coated silicon nanosheets as alternative to graphene: A perfect team for nanoelectronics

Silicon nanosheets are thin, two-dimensional layers with exceptional optoelectronic properties very similar to those of graphene. Albeit, the nanosheets are less stable. Now researchers at the Technical University of Munich (TUM) have, for the first time ever, produced a composite material combining silicon nanosheets and a polymer that is both UV-resistant and easy to process. This brings the scientists a significant step closer to industrial applications like flexible displays and photosensors.

Silicon nanosheets are thin, two-dimensional layers with exceptional optoelectronic properties very similar to those of graphene. Albeit, the nanosheets are...

Im Focus: Researchers Imitate Molecular Crowding in Cells

Enzymes behave differently in a test tube compared with the molecular scrum of a living cell. Chemists from the University of Basel have now been able to simulate these confined natural conditions in artificial vesicles for the first time. As reported in the academic journal Small, the results are offering better insight into the development of nanoreactors and artificial organelles.

Enzymes behave differently in a test tube compared with the molecular scrum of a living cell. Chemists from the University of Basel have now been able to...

All Focus news of the innovation-report >>>

Anzeige

Anzeige

Event News

International Land Use Symposium ILUS 2017: Call for Abstracts and Registration open

20.03.2017 | Event News

CONNECT 2017: International congress on connective tissue

14.03.2017 | Event News

ICTM Conference: Turbine Construction between Big Data and Additive Manufacturing

07.03.2017 | Event News

 
Latest News

Argon is not the 'dope' for metallic hydrogen

24.03.2017 | Materials Sciences

Astronomers find unexpected, dust-obscured star formation in distant galaxy

24.03.2017 | Physics and Astronomy

Gravitational wave kicks monster black hole out of galactic core

24.03.2017 | Physics and Astronomy

VideoLinks
B2B-VideoLinks
More VideoLinks >>>