Assessment of chloroquine as a modulator of immune activation to improve CD4 recovery in immune nonresponding HIV-infected patients receiving antiretroviral therapy

作者：Routy J P^*; Angel J B; Patel M; Kanagaratham C; Radzioch D; Kema I; Gilmore N; Ancuta P; Singer J; Jenabian M A

来源：HIV Medicine, 2015, 16(1): 48-56.

DOI：10.1111/hiv.12171

• antiretroviral therapy
• CD4 T-cell recovery
• chloroquine
• HIV
• Toll-like receptors

ObjectivesChloroquine (CQ), an anti-inflammatory drug, inhibits Toll-like receptor (TLR) signalling in plasmacytoid dendritic cells (pDCs) and may be beneficial for HIV-infected patients in whom immune activation persists despite effective antiretroviral therapy (ART). The effect of CQ on CD4 T-cell recovery and immune activation in immune nonresponding patients receiving successful ART was therefore studied.
MethodsNineteen adults on ART with CD4 counts 350cells/L and undetectable viral load (VL) orally received CQ at 250mg/day for 24 weeks. Side effects, CD4 and CD8 T-cell counts, VL, T-cell activation, pDC proportion and plasma inflammatory markers were assessed at baseline, at 24 weeks, and at 12 weeks after CQ discontinuation (clinicaltrial.org registration #NCT02004314).
ResultsCQ was well tolerated and all patients maintained an undetectable VL. The absolute CD4 and CD8 T-cell counts and their percentages, the pDC proportion, T-cell activation, D-dimer and C-reactive protein (CRP) plasma levels and the kynurenine/tryptophan ratio did not change with CQ treatment. Among nine cytokines/chemokines measured, only levels of interferon (IFN)-2 were significantly increased by CQ treatment.
ConclusionsCQ was well tolerated in patients with low CD4 T-cell counts despite long-term effective ART; however, 24 weeks of CQ treatment did not improved CD4 T-cell recovery, lymphoid and myeloid immune activation or inflammatory markers.

• 出版日期2015-1
• 单位McGill