Vaccines and Immunotherapies (VIT)
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.
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.
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.