#shock and kill

[hivforum]

What's the deal with Antabuse on activating latent HIV reservoir cells? Is this a shock-and-kill candidate? I am already taking it to prevent drinking, but this seems to be yet another reason to commit in the face of inevitable cravings. I'm religiously adherent on my HIV meds. Did not realize there was (possibly?) a relationship between Antabuse and HIV research until doing some of my own googling. Not trying to make you my psych, just curious if what I've heard re hiv has merit?

Disulfiram (Antabuse) has latency-reversing properties, meaning it can reactivate latent HIV in resting CD4 cells. This drug has been looked at as a candidate for the “shock” part of a “shock and kill” strategy. However, trials of disulfiram have not resulted in a reduction in the size of the latent reservoir, and no one expects “shock” to work by itself. Take your Antabuse to keep you from drinking, but don’t expect too much more from it.

[hivforum]

Both "shock and kill" and "kick and kill" sound like names of GWBush-era wars. Couldn't somebody come up with something a little gentler? I'd be hesitant to swallow a kill pill.

Don’t worry, I’m sure the marketing people will come up with something less alarming if this approach ever ends up working and getting approved.

[hivforum]

Doctor Gallant you recently wrote "What we’re interested in are drugs that stop HIV from replicating (we have a lot of them), and drugs that eliminate HIV DNA from the viral reservoir (we don’t have any)." My question is do we have any drugs that eliminate HIV DNA from the viral reservoir in development? If not, do we have any prospective avenues in current study? I think many would be interested in becoming aware of this. Additionally thank you for all the great work you do.

Thanks, and you’re welcome!

We do have drugs that are being studied for this purpose: so called “latency reversing agents” (LRAs) that activate or “wake up”infected resting CD4 cells. Examples include the histone deacetylase (HDAC) inhibitors. They’re being studied as part of a “shock and kill” or “kick and kill” approach, where you attack the replicating viruswith antiretroviral drugs after activating it with LRAs.

The main problem with this approach is that unless you activate every resting CD4 cell, you won’t have eradicated HIV. There are also other reservoirs for latent infection other than resting CD4 cells, which may not be activated in the same way. Still, this is a very active and exciting area of study.

[silence-is-behavior]

A new post regarding the historical movement of HIV-1 therapy is on in the Dr. Filion's la blog.