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Alcoholism Drug Brings HIV Out of Dormancy

Tags: HIV Research

A drug used to treat alcoholism also wakes up latent HIV reservoirs hiding in the bodies of people living with the disease.

And that’s good news, because now scientists have found a way to “kick” HIV out of it hiding spots with a drug that isn’t toxic.

In a study published this week in The Lancet HIV, scientists led by Julian H. Elliott of the University of Melbourne in Australia, together with researchers from University of California San Francisco, described how disulfiram roused the virus from cells were it sleeps.

In an experiment among 20 healthy, HIV-infected adults (undetectable viral load, or less than 50/ml, and a CD4 count greater than 350), participants were given 500 mg, 1000 mg and 2,000 mg of disulfiram daily for three days. “The dosage of disulfiram we used provided more of a ‘tickle’ than a ‘kick’ to the virus, but this could be enough,” said Sharon Lewin, University of Melbourne professor, in a news release. “Even though the drug was only given for three days, we saw a clear increase in virus in plasma, which was very encouraging.”

The drug was well tolerated at all doses. Disulfiram sometimes is prescribed to alcoholics because it causes unpleasant side effects when alcohol is consumed, discouraging drinking. Disulfiram interacts with some older HIV medications and should only be taken under a doctor’s supervision.

Although disulfiram rouses HIV out of hiding, that’s only half the battle -- albeit one that has proven difficult to overcome -- in finding a cure for the disease. “This trial clearly demonstrates that disulfiram is non-toxic and is safe to use, and could quite possibly be the game changer we need,” Lewin said.

Professor Steven Deeks from UCSF said the study is encouraging because other research aimed at dusting up latent HIV inside the body is focusing on more powerful agents that “may prove to be harmful. I see disulfiram as a more gentle way to accomplish this same goal, particularly if we can show it works when given over a long period of time.”

Lead researcher Elliott said the next step is figuring out how to get the latent cells to die once they’re knocked onto the battlefield. “This is a very important step as we have demonstrated we can wake up the sleeping virus with a safe medicine that is easily taken orally once a day. Now we need to work out how to get rid of the infected cell. A kick-start to the immune system might help. We have an enormous amount still to learn about how to ultimately eradicate this very smart virus.”

The study was funded by amfAR, National Institute of Allergies and Infectious Diseases (NIH) and Australia’s National Health and Medical Research Council. Researchers from Johns Hopkins University and Frederick National Laboratory also were part of the study team.