Assessment of chloroquine as a modulator of immune activation to improve CD4 recovery in immune nonresponding HIV-infected patients receiving antiretroviral therapy
Version of Record online: 2 JUN 2014
© 2014 British HIV Association
Volume 16, Issue 1, pages 48–56, January 2015
How to Cite
Routy, J.-P., Angel, J., Patel, M., Kanagaratham, C., Radzioch, D., Kema, I., Gilmore, N., Ancuta, P., Singer, J. and Jenabian, M.-A. (2015), Assessment of chloroquine as a modulator of immune activation to improve CD4 recovery in immune nonresponding HIV-infected patients receiving antiretroviral therapy. HIV Medicine, 16: 48–56. doi: 10.1111/hiv.12171
- Issue online: 12 DEC 2014
- Version of Record online: 2 JUN 2014
- Manuscript Accepted: 9 APR 2014
- CIHR Canadian HIV Trials Network. Grant Number: CTN 246
- Research Institute of the McGill University Health Centre
- Ontario HIV Treatment Network Career Scientist Award
- CANFAR/CTN Postdoctoral Fellowship Award
- antiretroviral therapy;
- CD4 T-cell recovery;
- Toll-like receptors
Chloroquine (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.
Nineteen adults on ART with CD4 counts ≤350 cells/μL and undetectable viral load (VL) orally received CQ at 250 mg/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).
CQ 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)-α2 were significantly increased by CQ treatment.
CQ 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.