August 12, 2005
The anti-convulsant drug valproic acid, when used in combination with highly active antiretroviral treatment, has shown promise in reducing the number of dormant cells infected with HIV, a finding that one day could lead to a cure for HIV/AIDS, according to preliminary research published in the Aug. 12 issue of the Lancet, the AP/USA Today reports. Currently available antiretroviral drugs work only when HIV is multiplying, which happens only when it is in an active cell. However, HIV also infects dormant cells, making the virus itself temporarily dormant and undetectable by antiretrovirals. Therefore, an HIV-positive person cannot be cured until all of the HIV-infected dormant cells can be identified and eradicated. In a proof of concept study, David Margolis of the University of North Carolina-Chapel Hill and colleagues gave four HIV-positive patients valproic acid -- which is used to treat such conditions as bipolar disorder and epilepsy -- twice a day for three months. The patients continued taking combination antiretroviral therapy. The researchers found that latent HIV infection reduced by 75% in three of the patients. Margolis said he believes the drug reactivates HIV in the dormant cell (AP/USA Today, 8/11).
"This finding, though not definitive, suggests that new approaches will allow the cure of HIV in the future," Margolis said (Clabby, Raleigh News & Observer, 8/12). Jean Pierre Routy of McGill University in Montreal said in an accompanying commentary to the Lancet study that the findings "merit urgent further study." Also, Chris Gadd of British HIV/AIDS information source Aidsmap cautioned against scientists being "overconfident about the eventual introduction of this approach in HIV treatment," adding, "This study is the first small step towards a fuller investigation, which may well result in this approach falling by the wayside" (BBC News, 8/11). Abraham Karpas of the University of Cambridge called the findings "absolute nonsense," adding that the scientists "don't understand the biology of the virus. We will cure every cancer before we find a cure for HIV. The only way to defeat this disease so far is to prevent infection" (Laurence, Independent, 8/12). Robert Sliciano of Johns Hopkins University also said he doubts that valproic acid will cure HIV because the virus probably lies dormant in other types of cells that scientists have not yet discovered. "It's a little bit premature to be talking about a cure for HIV," he said (AP/USA Today, 8/11).
Reprinted with permission from kaisernetwork.org. You can view the entire Kaiser Daily HIV/AIDS Report, search the archives, or sign up for email delivery at www.kaisernetwork.org/dailyreports/hiv. The Kaiser Daily HIV/AIDS Report is published for kaisernetwork.org, a free service of the Kaiser Family Foundation, by The Advisory Board Company. © 2004 by The Advisory Board Company and Kaiser Family Foundation. All rights reserved.