The results of the HCQ-01 trial, published in JAMA, show that the drug hydroxychloroquine does not slow down the damage caused by HIV.
The researchers had hoped that the drug, which is also used for treating other immune diseases, would decrease the amount of inflammation that the body produces in response to HIV. If this was the case it could slow down the damage HIV does to the immune system, meaning that people taking the drug could have waited longer before starting antiretroviral therapy. This would have been beneficial, as hydroxychloroquine has fewer side effects than antiretroviral therapy, and is cheap.
To see if this was the case, MRC CTU worked with 10 HIV clinics in the UK on the HCQ-01 trial. 83 patients with early HIV disease, who did not yet need antiretroviral therapy, took part. Half were given a daily dose of hydroxychloroquine for 48 weeks, while the other half were given a placebo. Surprisingly, the researchers found that hydroxychloroquine had a detrimental effect on two important disease markers: HIV viral load (the level of virus in the blood) and CD4 count (a type of white blood cell which is attacked by HIV). However, these effects were reversed when hydroxychloroquine was discontinued.
These results show the hydroxychloroquine has no role in the treatment of early HIV disease, and are a reminder of the need for rigorously-designed studies to assess new strategies.