Phototherapy of HIV-Infected Patients: Evidence Questioning and Addressing Safety

  • Ponciano D. CruzJr.

Abstract

Because most forms of medical treatment interfere with biological events in the course of accomplishing their beneficial task, unintended adverse effects are almost inevitable. Recent concern about the use of phototherapy in patients infected with the human immunodeficiency virus (HIV) illustrate this double-edged situation. Whereas the efficacy of ultraviolet (UV)B or PUVA (psoralen plus UVA) for the treatment of HIV-related psoriasis, eosinophilic folliculitis, atopic dermatitis, or pruritus is unchallenged, questions regarding safety have not been fully resolved.

Keywords

Migration Psoriasis Acetyl Dermatitis Thymidine 

Preview

Unable to display preview. Download preview PDF.

Unable to display preview. Download preview PDF.

References

  1. 1.
    Folks TM, Justement J, Kinter A, Dinarello CA, Fauci AS (1995) Cytokine-induced expression of HIV-1 in a chronically infected promonocyte cell line. Science 228: 800–802Google Scholar
  2. 2.
    Valerie K, Delers A, Bruck C, Thiriart C, Rosenberg H, Debouck C, Rosenberg M (1988) Activation of human immunodeficiency virus type i by DNA damage in human cells. Nature 33378–81Google Scholar
  3. 3.
    Stanley SK, Folks TM, Fauci AS (1989) Induction of expression of human immunodeficiency virus in a chronically infected promonocytic cell line by ultraviolet irradiation. AIDS Res Hum Retroviruses 5: 375–384PubMedCrossRefGoogle Scholar
  4. 4.
    Zmudzka BZ, Strickland AG, Miller SA, Valerie K, Dall’Acqua F, Beer JZ (1993) Activation of the human immunodeficiency virus promoter by UVA radiation in combination with psoralens or angelicins. Photochem Photobiol 58: 226–232PubMedCrossRefGoogle Scholar
  5. 5.
    Beer JZ, Olvey KM, Lee W, Zmudzka BZ (1994) Reassessment of the differential effects of ultraviolet and ionizing radiation on HIV promoter: the use of cell survival as the basis for comparisons. Photochem Photobiol 59643–649Google Scholar
  6. 6.
    Cavard C, Zider A, Vernet M, Bennoun M, Saragosti S, Grimber G, Briand P (1990) In vivo activation by ultraviolet rays of the human immunodeficiency virus type i long terminal repeat. J Clin Invest 86: 1369–1374PubMedCrossRefGoogle Scholar
  7. 7.
    Morrey JD, Bourn SM, Bunch TD, Jackson MK, Sidwell RW, Barrows LR, Daynes RA, Rosen CA (1991) In vivo activation of human immunodeficiency virus type i long terminal repeat by UV type A (UV-A) light plus psoralen and UV-B light in the skin of transgenic mice. J Virol 655045–5051Google Scholar
  8. 8.
    Vogel J, Cepeda M, Tschachler E, Napolitano LA, Jay G (1992) UV activation of human immunodeficiency virus gene expression in transgenic mice. J Virol 66: 1–5PubMedGoogle Scholar
  9. 9.
    Stern RS, Mills DK, Krell K, Zmudzka BZ (1998) HIV-positive patients differ from HIV-negative patients in indications for and type of UV therapy used. J Am Acad Dermatol 3948–55Google Scholar
  10. 10.
    Buchness MR, Lim HW, Hatcher VA, Sanchez M, Soter NA (1988) Eosinophilic pustular folliculitis in the acquired immunodeficiency syndrome. N Engl J Med 318: 1183 - n86PubMedCrossRefGoogle Scholar
  11. 11.
    Ranki A, Puska P, Mattinen S, Lagerstedt A, Krohn K (1991) Effect of PUVA on immunologic and virologic findings in HIV-infected patients. J Am Acad Dermatol 24: 404PubMedCrossRefGoogle Scholar
  12. 12.
    Pardo RJ, Bogaert MA, Penneys NS, Byrne GE, Ruiz P (1992) UVB phototherapy of the pruritic papular eruption of the acquired immunodeficiency syndrome. J Am Acad Dermatol 26: 423–428PubMedCrossRefGoogle Scholar
  13. 13.
    Meola T, Soter NA, Ostreicher R, Sanchez M, Moy JA (1993) The safety of UVB photo-therapy in patients with HIV infection. J Am Acad Dermatol 29: 216–220PubMedCrossRefGoogle Scholar
  14. 14.
    Horn TD, Morison WL, Farzadegan H, Zmudzka BZ, Beer JZ (1994) Effects of psoralen plus UVA radiation (PUVA) on HIV-1 in human beings: a pilot study. J Am Acad Dermatol 3i: 735–74oCrossRefGoogle Scholar
  15. 15.
    Fotiades J, Lim HW, Jiang SB, Soter NA, Sanchez M, Moy J (1995) Efficacy of ultraviolet B phototherapy for psoriasis in patients infected with human immunodeficiency virus. Photodermatol Photoimmunol Photomed 11:107-mGoogle Scholar
  16. 16.
    Fotiades J, Soter NA, Sanchez MR, Moy JA (1995) A three-year follow-up evaluation on 28 HIV-positive patients treated with ultraviolet B (UVB) phototherapy. J Invest Dermatol io4:66oaGoogle Scholar
  17. 17.
    Duvic M, Ulmer R, Crane M, Goller M, Adu-oppong A, Lewis DE (1995) Treatment of HIV+ patients with UVB is associated with a significant increase in p24 antigen levels. J Invest Dermatol 104: 581Google Scholar
  18. 18.
    Gelfand JM, Rudikoff D, Lebwohl M, Klotman ME (1998) Effect of UV-B phototherapy on plasma HIV type i RNA viral level: a self-controlled prospective study. Arch Dermatol 134940–945Google Scholar
  19. 19.
    Simpson E, Dawson B, Cruz PD Jr (1997) UVB radiation activates HIV in human skin. J Invest Dermatol 110: 485Google Scholar
  20. 20.
    Cruz PD Jr, Dougherty I, Ellinger L, Gilchrest BA (1997) Thymidine dinucleotides inhibit the induction of contact hypersensitivity and activate the gene for TNFa. J Invest Dermatol no: 491aGoogle Scholar
  21. 21.
    Romerdahl CA, Okamoto H, Kripke ML (1989) Immune surveillance against cutaneous malignancies in experimental animals. In: Norris DA (eds) Immune mechanisms in cutaneous disease. Dekker, New York, pp 749–769Google Scholar
  22. 22.
    Kripke ML, Morison WL (1986) Studies on the mechanism of systemic suppression of contact hypersensitivity by UVB radiation. II. Differences in the suppression of delayed and contact hypersensitivity in mice. J Invest Dermatol 86: 787–790Google Scholar
  23. 23.
    Ullrich SE (1996) Does exposure to UV radiation induce a shift to a Th-2-like immune reaction? Photochem Photobiol 64: 254–258PubMedCrossRefGoogle Scholar
  24. 24.
    Clerici M, Stocks NI, Zajac RA, Boswell RN, Lucey DR, Via CS, Shearer GM (1989) Detection of three distinct patterns of T helper cell dysfunction in asymptomatic, human immunodeficiency virus-seropositive patients. J Clin Invest 84: 1892–1899PubMedCrossRefGoogle Scholar
  25. 25.
    Clerici M, Shearer GM (1993) A TH1/TH2 switch is a critical step in the etiology of HIV infection. Immunol Today 14: 107–111PubMedCrossRefGoogle Scholar
  26. 26.
    Mosmann TR (1994) Cytokine patterns during the progression to AIDS. Science 265x93–194Google Scholar

Copyright information

© Springer-Verlag Berlin Heidelberg 2001

Authors and Affiliations

  • Ponciano D. CruzJr.

There are no affiliations available

Personalised recommendations