EFFECT OF UV-B PHOTOTHERAPY ON PLASMA HIV TYPE-1 RNA VIRAL LEVEL - A SELF-CONTROLLED PROSPECTIVE-STUDY

Objective: To study the plasma human immunodeficiency virus type 1 (HI V-1) RNA levels of 12 patients seropositive for HIV who were undergoin g UV-B phototherapy to determine if UV-B phototherapy upregulates HIV activity in humans. Design: A self-controlled prospective cohort of HI V-infected patients seen for the treatment of a skin disorder responsi ve to UV-B phototherapy. Viral levels were measured weekly for 8 weeks of phototherapy. Follow-up viral levels were measured for patients wh o continued phototherapy beyond 8 weeks, those who had a significant c hange in their viral level, or both. Setting: Outpatient clinic of an academic hospital. Patients: Patients with HIV disease and a skin diso rder responsive to UV-B phototherapy. Inclusion criteria for patients in this study were those receiving a stable antiviral regimen for at l east 6 weeks and who had no major illness or immunization in the 2 mon ths before starting phototherapy. Of 72 patient volunteers screened, 1 5 met the criteria, 2 declined to participate, and 13 entered the stud y. One patient was dropped from the study because an accurate baseline measurement could not be obtained. Twelve patients were analyzed, 2 o f whom left the study early, 1 at 6 weeks and 1 at 7 weeks. Interventi ons: Ultraviolet-B phototherapy. Main Outcome Measure: Plasma HIV-1 RN A viral level. Results: Plasma HIV-I RNA levels showed no significant increase or decrease in most of the patients, defined as a 3-fold chan ge from baseline (mean fold change from baseline after 8 weeks of phot otherapy, - 1.1; 95% confidence interval, 2.9 to -5.0). Trend analysis indicated no significant pattern of change in viral levels (slope,- 0 .013 log; P>.25). The CD4(+) cell counts also remained unchanged (mean before therapy, 277 X 10(9)/L; mean after therapy, 285 X 10(9)/L; P=. 67). Conclusion: No significant effect of UV-B exposure was seen on pl asma HIV-1 levels.