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Q J Med 2001; 94: 599-607
© 2001 Association of Physicians

Passive transfer of scrub typhus plasma to patients with AIDS: a descriptive clinical study

G. Watt, P. Kantipong1, K. Jongsakul, M. de Souza and T. Burnouf2

From the Retrovirology Department, USAMC, Armed Forces Research Institute of Medical Sciences (AFRIMS), Bangkok, Thailand, 1 Chiangrai Regional Hospital, Chiangrai, Thailand, and 2 Human Plasma Product Services, Lille, France

Received 3 July 2001 and in revised form 24 August 2001

We examined the HIV-inhibitory effects previously found to be associated with scrub typhus infection. Individual 500 ml units of plasma from donors with mild scrub typhus were safety-tested, subjected to virucidal heat treatment, and administered to 10 HIV-1-infected recipients who were not receiving antiretroviral drugs. HIV-1 copy number fell three-fold or more in two recipients, and virus burden was reduced for 8 weeks in 70% (7/10) of recipients of a single plasma infusion, compared with the mean of three pre-infusion measurements. Scrub typhus donor plasma inhibited HIV-1 in vitro compared with normal human plasma and media controls. In the clearest in vivo response, reduction in viral load was accompanied by clinical improvement, a switchback from the syncytia-inducing to the non-syncytia-inducing phenotype, and decreases in CD8 cells and IL-6 levels. Scrub typhus infections can generate heat-stable, transferable plasma factors that exert prolonged anti-HIV effects. Whether variability in the results is due to different scrub typhus infections, different HIV infections or different individual responses, is unclear.

Address correspondence to Dr G. Watt, DTM&H, Retrovirology Department, AFRIMS, APO AP 96546. e-mail: wattgh{at}thai.amedd.army.mil


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