Article

Prolonged valproic acid treatment does not reduce the size of latent HIV reservoir. AIDS

INSERM, U802, Bicêtre, France.
AIDS (London, England) (Impact Factor: 5.55). 06/2008; 22(10):1125-9. DOI: 10.1097/QAD.0b013e3282fd6ddc
Source: PubMed

ABSTRACT

To investigate the impact of prolonged valproic acid treatment on the HIV reservoir in patients on highly active antiretroviral therapy.
In a single-center pilot study, the size of the HIV reservoir of 11 patients receiving valproic acid for seizures for more than 2 years was compared with 13 matched patients. In addition, the outcome of patients receiving valproic acid in the French clinical trials of scheduled treatment interruption was recorded.
Total and integrated HIV-1 DNA in, respectively, peripheral blood mononuclear cells and CD4 T cells of the patients were quantified by real-time PCR methods. The frequency of CD4 T cells carrying replication-competent virus was estimated by a quantitative limiting-dilution assay in which virus growth was detected by RT-PCR in culture supernatants of activated CD4 T cells. Clinical charts of the patients included in scheduled treatment interruption trials receiving valproic acid were reviewed.
Total and integrated HIV DNA were logarithmically more abundant than cells carrying replication-competent virus, but there was no significant difference in these three parameters between the two groups of matched patients. Three patients receiving valproic acid were included in scheduled treatment interruption trials. The rebound of viral replication was similar to that of the other patients of the trials.
Long-term valproic acid therapy seems to be insufficient to reduce the size of the HIV-1 reservoir.

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    • "This allowed us to determine for each HDACI an optimal concentration (outlined by an arrow in Fig 2A and B) in terms of both their HIV-1 reactivation potential and their C max (mentioned at the bottom of Fig 2A and B). In our next experiments, we selected the following HDACI concentrations for combinatory treatments with 5-AzadC: (i) MS-275 at a concentration of 0.5 lM in agreement with C max ; (ii) NaBut at 1.5 mM consistent with C max ; (iii) SAHA at 1.25 lM in agreement with C max ; (iv) VPA at 2.5 mM, which is higher than C max but allowed HIV reactivation as opposed to VPA reactivation incapacity at C max used in clinical trials (Lehrman et al, 2005; Siliciano et al, 2007; Archin et al, 2008, 2010; Sagot-Lerolle et al, 2008; Routy et al, 2012a,b); (v) belinostat at 1 lM consistent with C max ; (vi) panobinostat at 0.15 lM corresponding to the dose initiating the plateau phase; and (vii) romidepsin at 0.0175 lM corresponding to an intermediate dose between the concentration initiating the plateau phase and C max . "
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    Preview · Article · Dec 2015 · EMBO Molecular Medicine
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    • "A first study reported a decrease in the frequency of circulating resting CD4þ T cells carrying replication competent HIV-1 in four patients receiving cART after 16 weeks of additional treatment with VPA (Lehrman et al., 2005). However, subsequent randomized clinical studies could not confirm these results and no significant effects of VPA were evidenced (Archin et al., 2010; Routy et al., 2012; Sagot-Lerolle et al., 2008; Steel et al., 2006). Failure of VPA was eventually associated to a poor capacity of this molecule to inhibit HDAC3, the HDAC isoform that is thought to play a preponderant role in HIV latency (Huber et al., 2011). "
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    • "Recently, VPA is under investigation for treatment of HIV and various cancers [6]. VPA not only suppresses tumor growth and metastasis, but also induces tumor differentiation in vitro and in vivo. "
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