The potential place of chloroquine in the treatment of HIV-1-infected patients

Background: Chloroquine has been reported to be endowed with anti-HIV-1 act ivity. We previously found its anti-HIV-1 activity to be additive to that o f of the hydroxyurea plus didanosine combination. Objectives: Here we wish to present reported data on chloroquine's effects other than its antiretrov iral activity, that may be of benefit in the therapy of HIV-1-infected indi viduals. Results: (1) Chloroquine exerts an inhibitory effect on several AI DS-opportunistic pathogens, at least in vitro and, in some cases, in murine infections. (2) The drug exerts an inhibitory effect on the synthesis of s everal pro-inflammatory cytokines that may play a pathogenic role in the pr ogression of HIV infection. (3) The drug has the potential to restrict tiss ular iron accumulation that may play a negative role in HIV infection. (4) The drug has practical advantages, as it is widely distributed, inexpensive and not stigmatizing. (5) We hypothesized that the drug, if given to HIV-p ositive breast-feeding mothers, may be of potential benefit in decreasing t he rate of mother-to-child transmission of HIV-1. Conclusion: in view of th e above-given data, combination therapy with chloroquine warrants clinical studies in HIV-1-infected patients, mainly in the setting of resource-poor countries. (C) 2001 Elsevier Science B.V. All rights reserved.