Hydroxychloroquine does not slow down the damage caused
25 July 2012
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.