REPORT OF THE SYMPOSIUM ON THE USE OF INTRAVENOUS GAMMA-GLOBULIN IN ADULTS INFECTED WITH THE HUMAN-IMMUNODEFICIENCY-VIRUS

On July 27, 1989, the International Conference on Molecular Aspects of Immune Response and Infectious Diseases devoted a symposium to the subject of the use of intravenous gamma globulin (IVIG) in acquired immunodeficiency syndrome (AIDS). The information presented confirmed that IVIG benefits human immunodeficiency virus (HIV)‐infected children with recurrent infections and that much remains to be learned about the influence of IVIG in adult AIDS. The symposium participants recognized the urgent need to develop randomized clinical trials using a control group to assess the efficacy of a treatment with IVIG in PGL (persistent generalized lymphadenopathy), ARC (AIDS‐related complex), and AIDS. To prepare this report, a committee was established, including individuals with expertise in immunology, immunopharmacology, microbiology, virology, infectious diseases, general medicine, and pediatrics and representing research experience in academia and hospitals. After an introduction to the report with a summary of immunotherapeutic agents under evaluation to treat HIV infection, section 1 lays out the present understanding of the disease pathogenesis. Section 2 then outlines the treatment of HIV‐seropositive individuals, discussing the uncertainties that any treatment entails. Section 3 discusses the rationale for treating HIV‐infected individuals with WIG, and Section 4 examines the major differences between IVIG and hyperimmuneglobulins for the treatment of HIV infection. Section 5 looks at IVIG as a mean to delay the emergence of opportunistic infections and restore immunocompetence in AIDS and related illnesses, and Sections 6 and 7 suggest a pilot protocol on the use of WIG in association with low‐dose or standard‐dose zidovudine (AZT). Limited time precluded the committee's addressing certain important aspects, and it must be remembered that, since this report represents the committee evaluations as of July 1989, the use of WIG in adults infected with HIV should be studied on a continuous basis according to more up‐todate knowledge of HIV infection. Copyright © 1990 Wiley Periodicals, Inc., A Wiley Company