A drug used to treat alcoholism is likely a “game changer” in the fight to cure HIV. According to a study published yesterday in the medical journal The Lancet, teams from the University of Melbourne and the University of California San Francisco found that disulfiram, a drug which has been traditionally used to produce the symptoms of a hangover when alcohol is consumed, also has the ability to bring dormant HIV out of hiding.
HIV has the troubling ability to remain dormant in a human body by integrating itself into the DNA of a host’s cells, resting in a latent state. While antiretroviral drugs can be used to reduce a patient’s total burden of HIV, maintain function of the immune system, and prevent opportunistic infections that often lead to death, retroviral drugs only attack actively-replicating HIV. This ability to rest in a latent state is the main obstacle to eliminating an HIV infection through conventional antiretroviral therapy.
In this study, 30 patents undergoing antiretroviral therapy were given disulfiram over a period of three days. In this time, the patients were given progressively higher doses of the drug. While the first two dosages (500 and 1000 mg) did not produce any measured effect, after the highest dose of 2000 mg was given on the last day, researchers found evidence that dormant HIV was being re-activated. Seven days after this last dose, the amount of virus RNA found in a patient’s blood was found to have increased 70 percent. At the 30-day mark, this amount increased 100 percent. Even though the drug was only given for three days, since the amount of virus RNA observed in the blood plasma showed a clear increase, it suggests the treatment was working as desired.
Importantly, this drug was administered without any observed side effects. This is critical because toxicity is a major concern among other drugs being evaluated for bringing HIV out of hiding. In an interview with The Guardian, Sharon Lewin, a University of Melbourne professor who led the work, said, “This trial clearly demonstrates that disulfiram is not toxic and is safe to use, and could quite possibly be the game changer we need.”
According to the researchers, the secret to disulfiram’s success is it doesn’t “shock” HIV out of hiding, as is the case for many other drugs being explored. Instead, disulfiram provides the virus with “more of a tickle,” which apparently is all that is needed to get the virus out into the open.
“Disulfiram may be suited for future studies of combination and prolonged therapy to activate latent HIV,” the researchers wrote. This means that the next step will be to test the HIV-awakening effects of disulfiram in combination with other drugs specifically designed to kill the virus.
According to the World Health Organization, approximately 39 million people have died due to HIV-related cases worldwide. At the end of last year, UNAids, the United Nations HIV program, reported an estimated 36.9 million people were living with HIV.