Keywords: Anemia, White cells, Rred
cells, T- cells, Lymphadenitis, Hodgekin's disease, Emaciation, Leucopenia, Adenocarcinoma
of sigmoid colon. Left semicolectomy, Metastatic lesion in the liver, Kaposi's sarcoma,
Oral thrush, Oral herpes simplex infection, Hairy leukoplakia, Anti-HCV (+), Zidovudine (ZDV), CD4, Interferon-A-2b, Lesions, Antiretroviral treatment,
Interferon administration, Aerosolized pentamidine, Pulmonary tuberculosis, Brain
infarcts, HIV seropositive, Left semicolectomy,
Ashler-Coller, Chemotherapy 5-FU, Lleucovorin, Analgesic effect, Fever, Pain, Interstitial
pneumonia, Cotrimoxazole, Intestinal cryptosporidiasis,ZDV, DDI, DDC.
Case histories of AIDS patients who received treatment with the PAP IMI 300
device.
Patient No. 1
Male, 32 years old
Name initials : AG/KY
Code number : 199, homosexual, HIV seropositive since 4-93.
Kaposi's sarcoma lesions in his arms and left leg since 6-94. Started
zidovudine (ZDV) and interferon-A-2b in 8-94. Lesions worsened and PAP IMI 300 treatments
were applied in 2-95. Interferon administration was then stopped but antiretroviral
treatment was continued. Following the PAP IMI 300 application, the patient's skin lesions
remained stable and have continued to remain stable up to now (12-95). The patient feels
better and stronger and he has gained weight. Consecutive CD4 counts (per mm3 ) were : 360
(8-94), 266 (1-95), 455 (4-5), 576 (6 -95), 558 (10-95). Blood count and biochemical
values remained stable.
Patient No. 2
Female, 32 years old
Name initials : IO/GE
Code number : 99, heterosexual, HIV seropositive since 9-89.
Herpes Zoster of right leg (12-89), hairy leucoplakia (3-90), oral
thrush (2-94), Kaposi's sarcoma lesions in her gums and palate (6-94). Interferon - A - 2b
was administered concomitantly with antiretroviral therapy, which was begun in 3-90 (ZDV,
DDI , DDC ).
She was also receiving aerosolized pentamidine ( allergic to
cotrimoxazole ). On February 1995 she refused to take interferon any longer.
PAP IMI 300 treatments were begun in February and applied for three
months.
During interferon treatment and PAP IMI 300 application, the oral
lesions remained stable. Her CD4 counts (cells/mm3 ) were 187 (6-94), 60 (12-94) 235 (end
of March 1995). But her compliance to the treatment regimen was rather poor. After three
months we lost touch with her as she failed to continue her treatments. After a few months
we learned that she was being followed up in another AIDS unit, where she had presented
pulmonary tuberculosis and brain infarcts. Her CD4 count had dropped below 50 cells/mm3.
In the absence of PAP IMI treatments CD 4 count is observed always to fall and never to
spontaneously rise. So, although a CD4 count was not taken immediately prior to the
commencement of PAP IMI treatments in 2-95, it can be assumed that the CD4 count at that
time was below 60, and not above.
Patient No. 3
Male, 59 years old
Name initials : MI/GE
Code number : 261, homosexual, HIV seropositive since 2-94.
Adenocarcinoma of sigmoid colon (6-93). Left semicolectomy ( stage C2,
Ashler-Coller ). Metastatic lesion in the liver (1-94). After the documentation of HIV-1
seropositivity, he is followed up in our department. He then received chemotherapy (5-FU
plus leucovorin), antiretroviral therapy and interferon -A-2b. On May 1995 PAP IMI 300
treatments were applied due to constant pain in the right upper quadrant of his abdomen.
Pain was significantly relieved and his general condition was improved. This analgesic
effect lasted for several weeks. Subsequently, his compliance to treatment was not very
good. Up to now he has shown no AIDS defining illness but other metastatic lesions
appeared in the liver and lumbar spine. CD4 counts (cells /mm3 ): 212 (2-94), 40 (10-94 ),
284 (6-95). Although a CD4 count was not taken immediately prior to the commencement of
PAP IMI treatments in 5-95, it can be assumed that the CD4 count at that time was below
40, and not above (see Case 3).
Patients No. 4
Male, 31 years old
Name initials : PA/ NI
Code number : 281, bisexual, HIV seropositive since 1989.
Kaposi's sarcoma lesions in skin and lung. PAP IMI 300 treatments were
applied only 5 times (7-95). His clinical situation worsened rapidly and the patient died
one month later. No comparable CD4 counts are available.
Patient No. 5
Male, 35 years old,
Name initials : KA/EV
Code number: 151, homosexual, HIV seropositive since 1-90.
He has shown no AIDS defining illness. Antiretroviral treatment since
11-93 ( ZDV, DDI, DDC). PAP IMI 300 treatments were applied in 7-95. 3TC plus ZDV were
begun in 9-95. CD4 counts (cells/mm3): 215 (5-94), 156 (7-94), 154 (11-94), 138 (2-95),
128 (5-95), 119 (8-95), 378 (11-95). He is still being treated with the PAP IMI 300 and in
excellent condition.
Patient No. 6
Male, 32 years old
Name initials : SE/MA
Code number : 131, homosexual, HIV seropositive since 1988. PCP (10-90).
Oral thrush (1-93). Oral herpes simplex infection (10-93). Hairy
leukoplakia (2-95). Antiretroviral treatment and PCP prophylaxis since 10-90. From April
1995 he reported intermittent fever. PAP IMI 300 treatments were applied on 7-95. His
general condition improved. Fever kept recurring to a lesser degree. 3TC plus ZDV begun on
9-95. Now he is in almost excellent condition and is still on the PAP IMI 300. CD4 counts
(cells/mm3): 11 (1-95), 6 ( 4-95 ), 12 (7-95), 5 (9-95), 4 (10-95).
Patient No. 7
Male, 34 years old
Name initials : VA/ IO
Code number : 260, bisexual, HIV seropositive since 1988. PCP (9-94).
CMV retinitis (10-95). Antiretroviral therapy since 2-94
(AZT, DDI, 3TC plus ZDV). PAP IMI 300 treatments were applied on 7-95 (only a few
applications). No comparable results have been forthcoming.
Patient No. 8
Male, 29 years old
Name initials : PS/PO
Code number : 259, homosexual, HIV seropositive since 1988.
Oral thrush (4-95). No AIDS defining illness. Antiretroviral therapy
since 2-94 (ZDV, DDI, DDC ). PAP IMI 300 treatments were applied on 7-95. He remains in
good condition. He began 3TC+ZDV on 9-95. CD4 counts (cells/mm3 ) : 63 (3-95 ), 55 ( 9-95
), 56 (10-95).
Patient No. 9
Male, 49 years old
Name initials : PA/KO
Code number : 28, bisexual, HIV seropositive since 5-85.
Oral herpes simplex infection (7-94). Oral thrush (2-95). Anti-HCV (+)
since 2-95. Antiretroviral treatment since 2-89 ( ZDV, DDI, DDC). PAP IMI 300 treatments
were applied on 7-95. He remains in a rather good and stable condition. CD4 counts
(cells/mm3): 7(11-94), 2 (6-95), 3 (10-95).
Patient No. 10
Male, 50 years old
Name initials : CH/KO
Code number : 305, homosexual, HIV seropositive since 5-95.
Interstitial pneumonia resolved with cotrimoxazole (6-95). Oral thrush
(6-95). Intestinal cryptosporidiasis (6-95). Kaposi's sarcoma in nose and left malar area
(7-95). Treatments with the PAP IMI 300 were applied (7-95) and interferon-A -2b was
administered (7-95). Lesions remained stable. Antiretroviral treatment since 6-95 (ZDV).
CD4 counts (cells/mm3): 190 (6-95), 60 (9-95).
Patient No. 11
Male, 29 years old
Name initials : KA/IO
Code number: 212, bisexual, HIV seropositive since 3-92.
Antiretroviral treatment since 2-95 (ZDV). Varicella (6-95).
Treatments with the PAP IMI 300 were applied on 10-95. He remains in very good condition.
CD4 counts (cells/mm3 ): 296 (2-95), 342 (5-95 ), 356 (9-95), 303 (12-95).
Viral load measurements are pending.
Patient No. 12
Female, 26 years old
Name initials : KA/MA
Code number : 255, heterosexual, HIV seropositive since 2-92.
Wife of patient No 11. Antiretroviral treatment since 3-94. Varicella
(6-95).
Treatment with the PAP IMI 300 was applied on 10-95.
She is in excellent condition. CD4 counts (cells/mm3 ): 440 (3-94), 578 (9-94), 488
(5-95), 463 (9-95), 415 (12-95). Viral load measurements are pending.
Conclusion
In conclusion, in four of our patients we noticed an improvement of
their clinical condition, in 6 their condition remained stable, while one patient showed a
worsening. The Kaposi's sarcoma lesions remained at least stable during the application
period. An increase of CD4 count was demonstrated in four of our patients. The increase
was quite remarkable in some of them. In three, the CD4 count remained rather stable while
there was a worsening in four of them. The study was approved by the Greek National Drug
Organization. It is also noteworthy that all patients have experienced no side effects or
adverse reactions during or after the PAP IMI 300 application. We must also note that all
patients were receiving antiretroviral treatment as well all the appropriate prophylactic
regimens.
Dr. Anthony Papadopoulos, Dr. John
Arkadianos and Dr. Anthony Scoullos are actively working on this study.
Dr. George D. Stergiou, MD Director 2nd Department of Internal Medicine and AIDS Unit 1st
IKA HOSPITAL Athens, GREECE
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