Interleukin-12 enhancement of antigen-specific lymphocyte proliferation correlates with stage of human immunodeficiency virus infection.

The effect of interleukin (IL)-12 on T lymphocyte function was assessed in 47 human immunodeficiency virus (HIV)-infected persons of different disease stages and 16 seronegative controls. Lymphoproliferative responses (LPR) were measured to various HIV and non-HIV antigens and mitogens using peripheral blood mononuclear cells cultured with or without IL-12. Without exogenous IL-12, 96% of HIV-seropositive persons responded to mitogens, 77% to >=1 non-HIV antigen, and 11% to >=1 HIV antigen. Supplementation with IL-12 augmented LPR of HIV-seropositive persons to non-HIV antigens; however, the effect was greatest for those with higher CD4 cells (40% vs. 9% for those with >200 vs. <=200 CD4 cells/mm3). Addition of IL-12 also enhanced LPR to HIV antigens in 30% of subjects. This effect was most pronounced for those with>500 CD4 cells/mm3 (56% [P<. 05]). These findings suggest that impaired T lymphocyte recognition of foreign antigen, including HIV, can be reconstituted in part for selected HIV-seropositive persons.

Zygomycosis (mucormycosis) and HIV infection: report of three cases and review.

We report three cases of zygomycosis (mucormycosis) occurring in three individuals infected with the human immunodeficiency virus (HIV) and review 12 other published cases. We present the only two case reports of disseminated zygomycosis in AIDS patients, and the only AIDS patient with renal zygomycosis to survive without nephrectomy, receiving intravenous (i.v.) amphotericin alone. Coinfection with zygomycosis and HIV is rare, occurs primarily in patients with low CD4+ lymphocyte counts, does not always require the usual predisposing conditions for zygomycosis, and may be the presenting opportunistic infection among HIV-infected persons. Transient episodes of neutropenia occurring within 4 months before presentation may be a risk factor for this disease. Zygomycosis may arise in multiple sites including the basal ganglia, cutaneous tissue, kidney, respiratory tract, and may be disseminated. Occurring more commonly in, but not restricted to, injection drug users, it is significantly associated with sites other than basal ganglia in those patients with advanced HIV disease or AIDS. The presenting symptoms are related to the site of involvement, and the illness may develop insidiously or progress rapidly to a fulminant course. Successful therapy usually consists of surgical debridement and intravenous amphotericin B. Overall mortality in this review is 40%, and is significantly associated with sites of disease inaccessible to surgical debridement.