       Document 0759
 DOCN  M9640759
 TI    Soluble tumor necrosis factor receptors as surrogate markers for the
       assessment of zidovudine treatment in asymptomatic HIV-1 infection.
 DT    9604
 AU    Godfried MH; van der Poll T; Mulder JW; Weverling GJ; Endert E; Lange
       JM; Sauerwein HP; Department of Internal Medicine, University of
       Amsterdam, The; Netherlands.
 SO    J Acquir Immune Defic Syndr Hum Retrovirol. 1995 Dec 15;10(5):531-9.
       Unique Identifier : AIDSLINE MED/96142215
 AB    In untreated, asymptomatic human immunodeficiency virus type 1 (HIV-1)
       infection, elevated serum concentrations of soluble receptors for tumor
       necrosis factor (sTNFR) types I and II are associated with progression
       to AIDS. To assess the utility of sTNFRs as markers for the assessment
       of antiretroviral treatment, sTNFRs were sequentially determined in 47
       asymptomatic HIV-1-infected men, who participated in a double-blind,
       randomized, placebo-controlled study. Progression to AIDS or severe
       AIDS-related complex occurred in six zidovudine (ZDV)- and six
       placebo-treated subjects. During ZDV treatment (n = 28) both types of
       sTNFRs declined compared with baseline and placebo, whereas they
       increased during placebo treatment (n = 19). A sustained decline of
       sTNFRs occurred only in subjects who experienced no disease progression.
       During the first 3 months of ZDV treatment, the hazard ratio for disease
       progression when sTNFR type II rose above the baseline value plus 5% was
       significantly increased (hazard ratio: approximately 25; 95% confidence
       interval: approximately 1.5-400; p < 0.03). Simultaneously determined
       CD4+ counts and serum neopterin levels showed a similar pattern in
       progressors and nonprogressors. Thus, in contrast to CD4+ counts and
       neopterin levels, sTNFR concentrations, especially those of the type II
       STNFR, appear to be valuable surrogate markers for monitoring the
       efficacy of ZDV treatment in asymptomatic HIV-1 infection.
 DE    Acquired Immunodeficiency Syndrome/BLOOD/DRUG THERAPY/  PHYSIOPATHOLOGY
       Adult  Antiviral Agents/*THERAPEUTIC USE  AIDS-Related
       Complex/BLOOD/DRUG THERAPY/PHYSIOPATHOLOGY  Biological Markers/ANALYSIS
       Biopterin/ANALOGS & DERIVATIVES/BLOOD  CD4 Lymphocyte Count  Disease
       Progression  Double-Blind Method  Follow-Up Studies  Human  HIV Core
       Protein p24/ANALYSIS  HIV Infections/BLOOD/*DRUG THERAPY/PHYSIOPATHOLOGY
       *HIV-1  Male  Receptors, Tumor Necrosis Factor/*ANALYSIS/CHEMISTRY
       Solubility  Support, Non-U.S. Gov't  Zidovudine/*THERAPEUTIC USE
       CLINICAL TRIAL  JOURNAL ARTICLE  MULTICENTER STUDY  RANDOMIZED
       CONTROLLED TRIAL

       SOURCE: National Library of Medicine.  NOTICE: This material may be
       protected by Copyright Law (Title 17, U.S.Code).

