CTN 246: Chloroquine to reduce T cell immune activation in HIV-infected individuals

Chloroquine as a modulator of T cell immune activation to improve CD4 recovery in HIV-infected participants receiving antiretroviral therapy: A proof-of-concept study

About The Study

Up to 30% of individuals successfully treated with ART do not achieve a strong CD4 T cell recovery and therefore, remain at risk for AIDS and non-AIDS infections and diseases. Among factors associated with low CD4 T cell recovery is T cell activation, which stimulates Toll-like receptors (TLR). TLR play a crucial role in this innate immune response. Researchers hope that by blocking TLR engagement by chloroquine, an antimalarial medication, T cell immune activation would be reduced and in turn would promote CD4 recovery when HIV replication is suppressed by ART.

Study Approach

The study recruited 19 HIV+ individuals with undetectable viral loads. Eligible participants received an oral dose of chloroquine (250 mg) once daily from week 8 through week 32. All participants were asked to have rectal biopsy samples (week 0 and week 32) to study T cell immune activation in the mucosa rectal site. Side effects, CD4 and CD8 T-cell counts, viral load, T-cell activation, and plasma inflammatory markers were assessed at baseline, at 24 weeks, and at 12 weeks after chloroquine discontinuation.

Results and Conclusion

Investigators found that chloroquine was well-tolerated and all patients maintained an undetectable VL. The overall conclusion was that chloroquine is well tolerated in patients with low CD4 T-cell counts, despite long-term effective ART; however, 24 weeks of chloroquine treatment did not improve CD4 T-cell recovery, lymphoid and myeloid immune activation, or inflammatory markers.

Background

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Study Approach

The study recruited 19 HIV+ individuals with undetectable viral loads. Eligible participants received an oral dose of chloroquine (250 mg) once daily from week 8 through week 32. All participants were asked to have rectal biopsy samples (week 0 and week 32) to study T cell immune activation in the mucosa rectal site. Side effects, CD4 and CD8 T-cell counts, viral load, T-cell activation, and plasma inflammatory markers were assessed at baseline, at 24 weeks, and at 12 weeks after chloroquine discontinuation.

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