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

QJM. 2001 Nov;94(11):599-607. doi: 10.1093/qjmed/94.11.599.

Abstract

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.

MeSH terms

  • Acquired Immunodeficiency Syndrome / immunology
  • Acquired Immunodeficiency Syndrome / therapy*
  • Acquired Immunodeficiency Syndrome / virology
  • Adoptive Transfer / methods
  • Adult
  • Blood Component Transfusion / methods
  • DNA, Viral / analysis
  • Endothelin-1 / blood
  • Female
  • HIV-1 / immunology*
  • Humans
  • Immunoglobulin E / blood
  • Interleukin-6 / blood
  • Interleukin-8 / blood
  • Lymphocyte Subsets
  • Male
  • Middle Aged
  • Orientia tsutsugamushi / immunology
  • Phenotype
  • Plasma / immunology
  • Plasma / virology
  • Proteinase Inhibitory Proteins, Secretory
  • Proteins / analysis
  • Scrub Typhus / blood*
  • Scrub Typhus / immunology
  • Viral Load

Substances

  • DNA, Viral
  • Endothelin-1
  • Interleukin-6
  • Interleukin-8
  • Proteinase Inhibitory Proteins, Secretory
  • Proteins
  • Immunoglobulin E