Effect of HIV-specific immune-based therapy in subjects infected with HIV-1 subtype E in Thailand

The effect of treatment with an inactivated gp120-depleted HIV-1 immunogen (Remune) was investigated in 30 men and women from Ramathibodi Hospital (Bangkok Thailand) with HIV-1 subtype E and CD4 cell counts of 300 and above. All subjects received intramuscular injections of Remune into the triceps muscle on day 1 and then at weeks 4 8 12 24 36 48 and 60. Remune treatment was well-tolerated with no serious side effects and augmented HIV-1-specific immune responses. Compared with baseline levels subjects experienced significant (p < 0.0001) increases in CD4 cell count CD4 cell percentage CD8 cell percentage and body weight. 14 subjects with detectable viral load on day 1 showed a decrease at week 60. Retrospective Western blot analysis identified 23 subjects with increased intensity of antibody bands and 15 patients showed development of new reactivities to HIV proteins especially toward p17 and p15. These findings suggest that HIV-specific immune-based therapeutic approaches to HIV-1 infection should be further examined in countries where access to expensive antiviral drug therapy is limited. An ongoing Phase II trial in Thailand and a Phase III trial in the US involving thousands of HIV-infected subjects will provide a database on the safety of Remune treatment.