Immunotherapy for Infectious Diseases

294 Wallis and Johnson
infections, cytokines may mediate accelerated progression of HIV disease. The objectives
of adjunctive immunotherapy for tuberculosis are also complex. In some
situations, such as MDR disease, clearance of bacilli may be enhanced by administration
of IL-2, IL-12, or IFN-�, or possibly by using inhibitors of the deactivating
cytokines TGF-� and IL-10. In other circumstances, such as in HIV coinfection, it may
be desirable to reduce the nonspecific inflammatory response—and thereby reduce
HIV expression—using inhibitors of TNF-� such as pentoxifylline, prednisone, or
soluble TNF receptor. Further clinical trials are needed to define the clinical role for
immunotherapy of tuberculosis and other mycobacterial infections.
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