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(Chest. 2001;120:662-666.)
© 2001 American College of Chest Physicians

The Role of Passive Immunization in HIV-Positive Patients*

A Case Report

Veljko Veljkovic, PhD; Radmila Metlas, PhD; Djorde Jevtovic, PhD and William W. Stringer, MD, FCCP

* From the Institute VINCA (Dr. Veljkovic), Belgrade, Yugoslavia; Diapharm (Dr. Metlas), Guernsey, England; AIDS Clinic (Dr. Jevtovic), Institute for Infectious and Tropical Diseases, Belgrade, Yugoslavia; and UCLA School of Medicine (Dr. Stringer), Harbor-UCLA Medical Center, Torrance, CA.

Correspondence to: William W. Stringer, MD, FCCP, Interim Chair, Department of Medicine, Chief, General Internal Medicine, Associate Professor of Medicine, UCLA School of Medicine, Harbor-UCLA Medical Center, 1000 West Carson St, Box 459, Torrance, CA 90509

An HIV-positive patient presented with pulmonary tuberculosis as her AIDS-defining diagnosis in 1993 and was effectively treated with 12 months of standard antituberculosis medications (isoniazide, rifampin, and pyrazinamide for 2 months). She received zidovudine for 6 weeks at the time of her diagnosis; however, because of patient preference, she has not received subsequent standard HIV medications (7 years). Her CD4 count at the time of diagnosis (1993) was 297/µL. Monthly passive immunotherapy was administered (fresh frozen plasma from HIV-negative blood donors with a significant titer for the anti-vasoactive intestinal peptide [VIP]/NTM antibody) from December 1993 to June 1994. Her CD4 count increased to > 400/µL during the passive immunotherapy and has remained stable for the past 6 years. The rational for the use of anti-VIP/NTM antibodies preparations in HIV, the possible mode of action of anti-VIP/NTM antibodies, the use of Ig preparations, and the role of exercise as a natural source of anti-VIP/NTM antibodies are discussed. This case report supports the potential therapeutic use of anti-VIP antibodies for treatment of HIV disease.

Key Words: aerobic exercise • AIDS • anti-vasoactive intestinal peptide/NTM antibodies • HIV • Ig preparations • passive immunization • tuberculosis






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