THE ANTIINFLAMMATORY AND ANTIVIRAL EFFECTS OF HYDROXYCHLOROQUINE IN 2PATIENTS WITH ACQUIRED-IMMUNODEFICIENCY-SYNDROME AND ACTIVE INFLAMMATORY ARTHRITIS

Objective. To report the antiinflammatory and antiviral effects of hyd roxychloroquine (HCQ) treatment in 2 patients with AIDS and inflammato ry arthritis. Methods. Two patients with AIDS and inflammatory arthrit is were treated with HCQ, which was given in a loading dose of 600 mg/ day. The maintenance dosage was calculated to remain below 6.5 mg/kg/d ay. Both patients had initial T cell subset studies; 1 patient, had se rum and plasma collected before and after 1 year of HCQ treatment. Ass ays were performed for T cell subsets, recoverable human immunodeficie ncy virus type 1 (HIV-1) RNA, mitogen- and antigen-specific proliferat ion, and interleukin-6 (IL-6) levels, New studies on the use of HCQ as an anti-HIV-1 agent are reviewed. Results. Both patients had a dramat ic decrease in their arthritis activity. Neither patient required immu nosuppressive therapy or developed an opportunistic infection, In the patient who was studied after 1 year of therapy, there was a 1-log dec rease in recoverable HIV-1 RNA, improved mitogen- and antigen-specific immune responses, and a large decrease in the IL-6 level while taking HCQ, Recent in vitro and in vivo assays in patients with HIV infectio n have shown similar antiviral and antiinflammatory effects from HCQ. Conclusion. HCQ may exert simultaneous antiinflammatory and antiviral effects in patients with HIV infection and inflammatory arthritis, If larger studies confirm this observation, it may be the drug of choice in this population of patients.