Neutrophil deficiency and dysfunction in HIV-infected patients

This paper describes abnormal neutrophil function in HIV-infected patients, as well as the in vitro effect of filgrastim (granulocyte colony stimulati ng factor) on neutrophil function in HIV infection. Research shows that HIV-infected patients have a variety of defects in neut rophil function, including abnormalities in chemotaxis, phagocytosis, and b acterial killing. Activation of neutrophils may also contribute to neutroph il dysfunction in HIV infection; it appears that neutrophils are activated at all stages of HIV disease, and this activation may result in a decreased ability to respond to a second stimulus in patients with CD4+ counts less than 200/cu mm. Accelerated neutrophil apoptosis (programmed cell death) ma y also contribute to impaired neutrophil function. Administration of filgra stim 300 mu g s.c. daily or every other day for eight days to HIV-infected patients with CD4+ cell counts less than 200/cu mm resulted in a marked dec rease in the rate of apoptosis compared with baseline. Since neutrophil activation, accelerated apoptosis, and functional defects appear to be reversible with administration of filgrastim, filgrastim may p otentially be useful in preventing and treating secondary infections in HIV -infected patients.