Interleukin-2 Therapy in Patients with HIV Infection

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Abstract
Abrams and other members of the writing committee (Oct. 15 issue)1 describe two trials of recombinant interleukin-2 therapy in combination with antiretroviral therapy: the Subcutaneous Recombinant, Human Interleukin-2 in HIV-Infected Patients with Low CD4+ Counts under Active Antiretroviral Therapy (SILCAAT) study and the Evaluation of Subcutaneous Proleukin in a Randomized International Trial (ESPRIT). The investigators conclude that the use of interleukin-2 does not provide any additional benefit to patients with human immunodeficiency virus (HIV) infection. However, among many patients with HIV infection, testing for the virus is performed late in the course of the disease,2 which leads to the development of early opportunistic infections3 and death.4 The authors state that 49 cases of opportunistic disease occurred in the group that received the combined therapy, whereas 66 such cases occurred in the group that received antiretroviral therapy alone (hazard ratio, 0.73; 95% confidence interval, 0.51 to 1.06; P=0.10). Deaths from any cause were more frequent than opportunistic disease and were well balanced between the two study groups.