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February 8, 2011

New Cure-Related Research: Antabuse to Flush HIV Reservoir

A new clinical trial has just gotten underway to test the ability of Antabuse (disulfiram)—a drug used for years to treat alcoholism—to flush out the hidden reservoir of HIV that evades both the immune system and antiretroviral (ARV) drugs. Though the trial will be small and isn’t seeking to cure the study participants, it could help propel HIV cure research forward.

Experts in the field of virology and immunology haven’t given up on the possibility of a cure for HIV disease, and in recent years they’ve begun to test numerous strategies to flush out the reservoirs of HIV that hide within long-lived cells in the gut, brain and other sanctuary sites. These cells, most of which are in a resting state, are outside the reach of current ARVs—none of which work in resting cells—and the immune system, which has a hard time identifying and killing infected cells when they aren’t in an activated state.

Scientists believe that in order to flush the virus out of resting cells, the cells have to be activated, and research attention is currently focused on finding drugs with the power to do just that. Antabuse is one such drug. It has been in use for years to treat alcoholism—it makes people who drink alcohol become ill. Antabuse is now available as a generic drug, and it has a well-documented safety profile, making it an ideal candidate for testing.

Aside from making people feel terrible when they drink, Antabuse also has the ability to activate immune cells. Whether it can activate latently infected cells and make them vulnerable to HIV treatment and the immune system is not yet known, and that is what the study seeks to understand. In the trial, people will add 400 milligrams of Antabuse once a day to their current ARV regimen for two weeks, and then be followed for six months to look for signs of immune activation.

It is likely that Antabuse would have to be added to other immune-activating drugs in order to achieve a cure. Also, it is not yet known how long a person would have to be on such medications to flush out the reservoir. Nevertheless, if researchers can prove that Antabuse is able to activate latently infected cells, it could go into wider scale testing in combination with other drugs with the goal of achieving eradication.

The trial is currently recruiting volunteers in Baltimore and San Francisco (information on the trial can be found here) and expects to produce data by the summer of 2012.

Search: Antabuse, disulfiram, cellular activation, immune activation, latent cells, HIV reservoir

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