Valproic acid without intensified antiviral therapy has limited impact on persistent HIV infection of resting CD4+ T cells.

Published

Journal Article

OBJECTIVES: Valproic acid and intensified antiretroviral therapy may deplete resting CD4+ T-cell HIV infection. We tested the ability of valproic acid to deplete resting CD4+ T-cell infection in patients receiving standard antiretroviral therapy. METHODS: Resting CD4+ T-cell infection was measured in 11 stably aviremic volunteers twice prior to, and twice after Depakote ER 1000 mg was added to standard antiretroviral therapy. Resting CD4+ T-cell infection frequency was measured by outgrowth assay. Low-level viremia was quantitated by single copy plasma HIV RNA assay. RESULTS: A decrease in resting CD4+ T-cell infection was observed in only four of the 11 patients. Levels of immune activation and HIV-specific T-cell response were low and stable. Valproic acid levels ranged from 26 to 96 microg/ml when measured near trough. Single copy assay was performed in nine patients. In three patients with depletion of resting CD4+ T-cell infection following valproic acid, single copy assay ranged from less than 1-5 copies/ml. Continuous low-level viremia was observed in three patients with stable resting CD4+ T-cell infection (24-87, 8-87, and 1-7 copies/ml respectively) in whom multiple samples were analyzed. CONCLUSION: The prospective addition of valproic acid to stable antiretroviral therapy reduced the frequency of resting CD4+ T-cell infection in a minority of volunteers. In patients in whom resting CD4+ T-cell infection depletion was observed, viremia was rarely detectable by single copy assay.

Full Text

Duke Authors

Cited Authors

  • Archin, NM; Eron, JJ; Palmer, S; Hartmann-Duff, A; Martinson, JA; Wiegand, A; Bandarenko, N; Schmitz, JL; Bosch, RJ; Landay, AL; Coffin, JM; Margolis, DM

Published Date

  • June 19, 2008

Published In

Volume / Issue

  • 22 / 10

Start / End Page

  • 1131 - 1135

PubMed ID

  • 18525258

Pubmed Central ID

  • 18525258

Electronic International Standard Serial Number (EISSN)

  • 1473-5571

Digital Object Identifier (DOI)

  • 10.1097/QAD.0b013e3282fd6df4

Language

  • eng

Conference Location

  • England