Highly active antiretroviral treatment against STLV-1 infection combining reverse transcriptase and HDAC inhibitors

Blood. 2010 Nov 11;116(19):3802-8. doi: 10.1182/blood-2010-02-270751. Epub 2010 Jun 29.

Abstract

Approximately 3% of all human T-lymphotropic virus type 1 (HTLV-1)-infected persons will develop a disabling inflammatory disease of the central nervous system known as HTLV-1-associated myelopathy/tropical spastic paraparesis, against which there is currently no efficient treatment. As correlation exists between the proviral load (PVL) and the clinical status of the carrier, it is thought that diminishing the PVL could prevent later occurrence of the disease. We have conducted a study combining valproate, an inhibitor of histone deacetylases, and azidothymidine, an inhibitor of reverse transcriptase, in a series of baboons naturally infected with simian T-lymphotropic virus type 1 (STLV-1), whose PVL was equivalent to that of HTLV-1 asymptomatic carriers. We show that the combination of drugs caused a strong decrease in the PVL and prevented the transient rise in PVL that is seen after treatment with histone deacetylases alone. We then demonstrate that the PVL decline was associated with an increase in the STLV-1-specific cytotoxic T-cell population. We conclude that combined treatment with valproate to induce viral expression and azidothymidine to prevent viral propagation is a safe and effective means to decrease PVL in vivo. Such treatments may be useful to reduce the risk of HAM/TSP in asymptomatic carriers with a high PVL.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Animals
  • Antiretroviral Therapy, Highly Active
  • Antiviral Agents / administration & dosage*
  • CD8-Positive T-Lymphocytes / drug effects
  • CD8-Positive T-Lymphocytes / immunology
  • Deltaretrovirus Infections / drug therapy
  • Deltaretrovirus Infections / immunology
  • Deltaretrovirus Infections / veterinary*
  • Deltaretrovirus Infections / virology
  • Disease Models, Animal
  • Drug Therapy, Combination
  • Female
  • HTLV-I Infections / drug therapy
  • HTLV-I Infections / virology
  • Histone Deacetylase Inhibitors / administration & dosage*
  • Humans
  • Male
  • Monkey Diseases / drug therapy*
  • Monkey Diseases / immunology
  • Monkey Diseases / virology
  • Papio*
  • Paraparesis, Tropical Spastic / drug therapy
  • Paraparesis, Tropical Spastic / virology
  • Reverse Transcriptase Inhibitors / administration & dosage*
  • Simian T-lymphotropic virus 1*
  • T-Lymphocyte Subsets / drug effects
  • T-Lymphocyte Subsets / immunology
  • Valproic Acid / administration & dosage
  • Viral Load / drug effects
  • Zidovudine / administration & dosage

Substances

  • Antiviral Agents
  • Histone Deacetylase Inhibitors
  • Reverse Transcriptase Inhibitors
  • Zidovudine
  • Valproic Acid