Neutrophil deficiency and dysfunction in HIV-infected patients.

Abstract

This paper describes abnormal neutrophil function in HIV-infected patients, as well as the in vitro effect of filgrastim (granulocyte colony stimulating factor) on neutrophil function in HIV infection. Research shows that HIV-infected patients have a variety of defects in neutrophil function, including abnormalities in chemotaxis, phagocytosis, and bacterial killing. Activation of neutrophils may also contribute to neutrophil 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) may also contribute to impaired neutrophil function. Administration of filgrastim 300 microg 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 decrease 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 potentially be useful in preventing and treating secondary infections in HIV-infected patients.