Prolonged valproic acid treatment does not reduce the size of latent HIV reservoir.
OBJECTIVE
To investigate the impact of prolonged valproic acid treatment on the HIV reservoir in patients on highly active antiretroviral therapy.


METHODS
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.


METHODS
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.


RESULTS
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.


CONCLUSIONS
Long-term valproic acid therapy seems to be insufficient to reduce the size of the HIV-1 reservoir.
INSERM, U802, Bicêtre, France.
Nathalie
N
Sagot-Lerolle
Aurelia
A
Lamine
Marie-Laure
ML
Chaix
Faroudy
F
Boufassa
Jean-Paul
JP
Aboulker
Dominique
D
Costagliola
Cécile
C
Goujard
Coralie
C
Pallier
Coralie
C
Paller
Jean-François
JF
Delfraissy
Olivier
O
Lambotte
D000328:Adult; D000927:Anticonvulsants / Q000627:therapeutic use; D023241:Antiretroviral Therapy, Highly Active; D015496:CD4-Positive T-Lymphocytes / Q000821:virology; D016022:Case-Control Studies; D004279:DNA, Viral / Q000378:metabolism; D004791:Enzyme Inhibitors / Q000627:therapeutic use*; D005260:Female; D015658:HIV Infections / Q000188:drug therapy*; D015497:HIV-1; D056572:Histone Deacetylase Inhibitors; D006801:Humans; D007963:Leukocytes, Mononuclear / Q000821:virology; D008297:Male; D008875:Middle Aged; D010865:Pilot Projects; D020133:Reverse Transcriptase Polymerase Chain Reaction; D012640:Seizures / Q000188:drug therapy; D014635:Valproic Acid / Q000627:therapeutic use*
D000927:Anticonvulsants; D004279:DNA, Viral; D004791:Enzyme Inhibitors; D056572:Histone Deacetylase Inhibitors; D014635:Valproic Acid