Combination therapy with vorinostat, hydroxychloroquine and maraviroc had no effect on viral rebound in individuals interrupting HIV treatment who had started antiretrovirals (ARVs) during acute (very early) infection. Researchers in the SEARCH 019 trial conducted a randomized proof-of-concept study of the HDAC inhibitor vorinostat (a cancer drug being investigated as a part of HIV cure “kick and kill” methods), the immunosuppressant hydroxychloroquine and the ARV maraviroc given for 10 weeks with combination ARV treatment to 10 HIV-positive people who had started treatment during acute infection, were virally suppressed for at least 48 weeks and had at least 450 CD4s.
A control group of five people who fit the same profile received only combination ARV treatment for 10 weeks. At the end of the 10 weeks, all participants interrupted their HIV treatment.
Results were presented at the 21st International AIDS Conference in Durban, South Africa (AIDS 2016).
The exact protocol of those in the treatment arm of the study was 10 weeks of cycles of two weeks on and two weeks off of 400 milligrams per day of vorinostat plus a consistent 10 weeks of 400 mg per day of hydroxychloroquine and 1,200 mg per day of Selzentry.
The participants largely had been virally suppressed for about three years.
Two individuals in the treatment arm experienced serious adverse health events, with one quitting the study because of kidney failure and low platelets.
Fourteen people interrupted their treatment, including nine in the treatment arm and five in the control group. All of them experienced viral rebound within 14 to 77 days, and a median of 22 days, with no difference between the study arms.