The immunomodulatory effects of thalidomide on human immunodeficiency virus-infected children

The safety and immune effects of low-dose thalidomide treatment (3 mg/kg/da y for 28 days) were evaluated in a study involving 8 South African human im munodeficiency virus (HIV)-infected children. The children were 7-69 months old and in disease stages A1-C3. Thalidomide therapy did not affect virus load, even though none of the children was receiving antiretroviral therapy . Thalidomide stimulated CD8(+) T cells in peripheral blood, which increase d expression of the activation markers CD38 and human leukocyte antigen DR and of the memory cell marker CD45RO. The frequency of HIV gag-specific CD8 (+) T cells in peripheral blood increased in 3 of 4 children who were evalu ated during treatment with thalidomide. Clinical adverse events were mild. In this study, thalidomide was found to be safe and well tolerated and caus ed significant immunomodulation at a low dose. This is the first report des cribing use of an oral drug that may enhance HIV-specific CD8(+) T cell fun ction in HIV-infected children.