Suppression of beta₂ microglobulin by pentoxiphylline therapy in asymptomatic HIV infected individuals

Pentoxiphylline, an inhibitor of tumor necrosis factor-α (TNF-α) has been used in the treatment of human immunodeficiency virus (HIV) infection. The inhibition of TNF-α results in decreased immune activation. Beta₂ microglobulin (β₂M) has been used as a surrogate marker to study the progression of HIV infection. The objective of this study was to see if use of pentoxiphylline resulted in any decline in β₂M levels. Twenty patients with HIV infection who were free of opportunistic infections at the time of inclusion in the study and 18 age and sex matched controls were studied. β₂M was measured using an enzyme immunoassay before and four weeks after the start of treatment with pentoxiphylline. Mean levels of β₂M before therapy were 1.51 ± 0.77 mg/l (range 0.78 - 3.8 mg/l) and were significantly higher (P < 0.001) than the levels among controls [0.72 ± 0.06 mg/l (range 0.46 - 0.88 mg/l)]. β₂M levels in patients declined to 0.85 ± 0.22 mg/l (range 0.72 - 1.0 mg/l) after four weeks of therapy and this was statistically significant (P < 0.001). Use of pentoxiphylline for four weeks results in a significant decline in the levels of β₂M suggesting that the level of immune activation is reduced with the therapy.