VIRAL-SPECIFIC IMMUNIZATION IN AIDS-RELATED COMPLEX BY PHOTOPHERESIS

Human immunodeficiency virus (HIV) is a pathogenic retrovirus and the causative agent of acquired immunodeficiency syndrome (AIDS) and related disorders. In HIV infection the immunoprotective factors induced by initial infection seem to persist in those who remain healthy but are lost in those who develop full-blown AIDS, an event which may occur over a period of several years. The primary target for human immunodeficiency virus (HIV) infection is the CD4 lymphocyte cell population. Additional susceptible cell types include those of the macrophage/monocyte lineage. The mechanism underlying the CD4 cell depletion that occurs in vivo in HIV infection may involve indirect and undefined cytopathic processes, cell fusion and possibly an autoimmune mechanism.1 The potential therapeutic value of photopheresis was evaluated in 7 patients with AIDS-related complex (ARC). The rationale for the study was based on: 1. the demonstration that psoralen and UVA could inactivate virus2 and specifically HIV in vitro3 and possibly in vivo;4 2. CD4 cells are the primary target population affected by HIV and by photopheresis;5 and 3. reinfusion of inactivated virus and cell-associated virus might serve to engender a specific immune response. The current study represents an extension of the initial preliminary trial4 to include two additional patients.