Effects of Intermittent IL-2 Alone or with Peri-Cycle Antiretroviral Therapy in Early HIV Infection: The STALWART Study

BackgroundThe Study of Aldesleukin with and without antiretroviral therapy (STALWART) evaluated whether intermittent interleukin-2 (IL-2) alone or with antiretroviral therapy (ART) around IL-2 cycles increased CD4(+) counts compared to no therapy.MethodologyParticipants not on continuous ART with > or = 300 CD4(+) cells/mm(3) were randomized to: no treatment; IL-2 for 5 consecutive days every 8 weeks for 3 cycles; or the same IL-2 regimen with 10 days of ART administered around each IL-2 cycle. CD4(+) counts, HIV RNA, and HIV progression events were collected monthly.Principal findingsA total of 267 participants were randomized. At week 32, the mean CD4(+) count was 134 cells greater in the IL-2 alone group (p<0.001), and 133 cells greater in the IL-2 plus ART group (p<0.001) compared to the no therapy group. Twelve participants in the IL-2 groups compared to 1 participant in the group assigned to no therapy experienced an opportunistic event or died (HR 5.84, CI: 0.59 to 43.57; p = 0.009).ConclusionsIL-2 alone or with peri-cycle HAART increases CD4(+) counts but was associated with a greater number of opportunistic events or deaths compared to no therapy. These results call into question the immunoprotective significance of IL-2-induced CD4(+) cells.Trial registrationClinicalTrials.gov NCT00110812

ASSISTÊNCIA DE ENFERMAGEM E AS SEQÜELAS NEUROLÓGICAS DO SARAMPO

As seqüelas neurológicas do sarampo podem ocorrer como conseqüência de encefalites ou constituir o quadro chamado pan-encefalite esclerosante sub-aguda (PEESA). As encefalites são letais em cerca de 15 a 18% dos casos, causando danos permanentes (motores e/ou mentais) em aproximadamente 25% dos pacientes. A PEESA é sempre letal. Enfatiza-se as conseqüências sociais e econômicas destes problemas. Sugere-se assistência de enfermagem de acordo com os níveis de prevenção de Leave 11 & Clark.The neurological sequelae after measles can be encephalitis or subacute sclerosing pan-encephalitis (SSPE). The encephalitis is lethal in 15-18% of the patients, that can rest handiccaped at 25%. The SSPE is always lethal. The social and economical consequences of these problems are emphaised. It is suggested nursing care by Leavell & Clark levels of prevention