Background: there is a dramatic need for drugs with anti-HIV-1 activity tha
t are affordable for resource-poor countries. Chloroquine (CQ) is one such
drug. Objectives: to review the data indicating that CQ has anti-HIV-1 acti
vity. Results: chloroquine (CQ) and its derivative hydroxychloroquine (HCQ)
are endowed with a broad anti-HIV-1 activity inhibiting X4, R5, and X4/R5
stains in lymphocytic and monocytic cells. Interestingly, CQ is capable of
inhibiting HIV-1 replication at concentrations within the range reported in
plasma of individuals chronically treated with doses of the drug which hav
e well-known and limited toxicity. These effects have been confirmed in viv
o in two clinical trials. The principal mechanism of HIV-1 inhibition by CQ
seems to be an effect on gp120 on a post-transcriptional level. Because CQ
and HCQ appear to have a novel site of action (i.e. post-transcriptional i
nhibition of gp120), these drugs may be particularly useful in combination
with other anti-retroviral agents (e.g. ZDV, ddI and HU). Conclusion: combi
ning these drugs with other anti-HIV-1 agents, especially HU and ddI, may b
e an interesting option for the treatment for HIV-1 infected individuals in
the developing world. (C) 2001 Elsevier Science B.V. All rights reserved.