Publication: Clinical outcomes and immune benefits of anti-epileptic drug therapy in HIV/AIDS
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2010-06-17
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14712377
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2-s2.0-77953579619
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Mahidol University
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BMC Neurology. Vol.10, (2010)
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Kathy Lee, Pornpun Vivithanaporn, Reed A. Siemieniuk, Hartmut B. Krentz, Ferdinand Maingat, M. John Gill, Christopher Power (2010). Clinical outcomes and immune benefits of anti-epileptic drug therapy in HIV/AIDS. Retrieved from: https://repository.li.mahidol.ac.th/handle/123456789/29623.
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Clinical outcomes and immune benefits of anti-epileptic drug therapy in HIV/AIDS
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Abstract
Background: Anti-epileptic drugs (AEDs) are frequently prescribed to persons with HIV/AIDS receiving combination antiretroviral therapy (cART) although the extent of AED use and their interactions with cART are uncertain. Herein, AED usage, associated toxicities and immune consequences were investigated.Methods: HIV replication was analysed in proliferating human T cells during AED exposure. Patients receiving AEDs in a geographically-based HIV care program were assessed using clinical and laboratory variables in addition to assessing AED indication, type, and cumulative exposures.Results: Valproate suppressed proliferation in vitro of both HIV-infected and uninfected T cells (p <0.05) but AED exposures did not affect HIV production in vitro. Among 1345 HIV/AIDS persons in active care between 2001 and 2007, 169 individuals were exposed to AEDs for the following indications: peripheral neuropathy/neuropathic pain (60%), seizure/epilepsy (24%), mood disorder (13%) and movement disorder (2%). The most frequently prescribed AEDs were calcium channel blockers (gabapentin/pregabalin), followed by sodium channel blockers (phenytoin, carbamazepine, lamotrigine) and valproate. In a nested cohort of 55 AED-treated patients receiving cART and aviremic, chronic exposure to sodium and calcium channel blocking AEDs was associated with increased CD4+ T cell levels (p <0.05) with no change in CD8+ T cell levels over 12 months from the beginning of AED therapy.Conclusions: AEDs were prescribed for multiple indications without major adverse effects in this population but immune status in patients receiving sodium or calcium channel blocking drugs was improved. © 2010 Lee et al; licensee BioMed Central Ltd.