title: The enigma of the clandestine association between chloroquine and HIV-1 infection.
abstract: OBJECTIVE
  The antimalarial drug chloroquine (CQ) dampens the immune system and is used in the treatment of autoimmune disorders. CQ also shows antiviral activity against nonenveloped and enveloped viruses, including HIV-1. Persistent immune activation in chronic HIV-1infection leads to CD4 T-cell depletion. CQ is envisioned to attenuate immune activation and virus activity in HIV-1-infected patients. The role of CQ in immune activation and virus activity is discussed here.
  
  
  METHODS
  To elucidate the effect of CQ on immune activation, a retrospective review of published clinical trials, in vivo experimental studies in animals, and the most relevant in vitro observations in HIV-1-infected cells, together with observations from our own laboratory studies, was carried out and the findings discussed.
  
  
  RESULTS
  In a few clinical studies and animal experiments, CQ was ineffective in decreasing immune activation and HIV-1 infection. In vitro, CQ markedly increased HIV-1 infection in astrocytes and other non-CD4 cells.
  
  
  CONCLUSIONS
  The use of CQ in HIV-1-infected patients is questionable. The evidence for a dampening of immune activation by CQ is inconclusive.
authors.affiliation: Department of Pathology, Microbiology and Immunology, University of South Carolina School of Medicine, Columbia, SC, USA.
authors.forename: A
authors.initials: A
authors.lastname: Chauhan
authors.affiliation: Department of Pathology, Microbiology and Immunology, University of South Carolina School of Medicine, Columbia, SC, USA.
authors.forename: A
authors.initials: A
authors.lastname: Tikoo
mesh_terms: D000818:Animals; D000962:Antimalarials / Q000627:therapeutic use*; D015551:Autoimmunity / Q000187:drug effects*; D015496:CD4-Positive T-Lymphocytes / Q000276:immunology; D002738:Chloroquine / Q000627:therapeutic use*; D002986:Clinical Trials as Topic; D015658:HIV Infections / Q000188:drug therapy* / Q000276:immunology; D015497:HIV-1 / Q000187:drug effects*; D006801:Humans
chemical_list: D000962:Antimalarials; D002738:Chloroquine
keywords: HIV-1; chloroquine; endocytosis; immune activation; non-CD4 cells