Study on local inflammatory reactions and other parameters during subcutaneous mistletoe application in HIV-positive patients and HIV-negative subjects over a period of 18 weeks

Subcutaneous injections of fermented and unfermented aqueous extracts of Vi scum album L. result in a local inflammatory reaction at the injection site . Ln this trial, the symptoms associated with this local reaction were inve stigated. Furthermore the occurrence of local reactions was tried to correl at with an increase in CD3/25- and CDS/38-positive lymphocyte counts, with eosinophilic granulocyte numbers, and with the formation of mistletoe lecti n antibodies. Included in the trial were 30 HIV-antibody-positive patients and 17 healthy non-smokers, aged 24-51 years. The CD4 cell count in the HIV -negative subjects was >800/mu l, compared with 200-600/mu l in the HIV-pos itive patients. All study participants had a Kurnofsky score greater than o r equal to 70. The trial subjects were observed over a period of 18 weeks. With escalation of the dose of a fermented and unfermented extract of Viscu m album L. (Iscador(R) Qu Spezial and Viscum album QuFrF). there was an inc rease in local reactions. Erythema at the injection site was the most frequ ently reported symptom. Between the doses and the symptoms induration. swel ling and pruritus were marked correlations. Effects of the application of m istletoe extracts on the immune system were demonstrated by an increase in CD3/25-positive lymphocyte counts and antibodies against mistletos-lectins. There were no changes in eosinophilic granulocytes or CD3/25-positive lymp hocyte populations. For evaluation of the therapeutic applications of mistletoe extracts in HIV -positive patients it is advisable to assess primarily activation of CD3-po sitive lymphocytes and the patient response on the basis of the local react ion. The local inflammatory reaction at the injection site is desirable and well tolerated if the reaction is smaller than 5 cm in diameter.