Nail anti-fungal drug soon to be HIV medicine


O ver the past several decades, scientists have recorded major strides in the fight against the HIV/AIDS pandemic that continues to threaten millions of lives.

The tide, however, is turning in the fight against the pandemic ‑ thanks to medical advancement, which, according to the UN, has resulted in a decline in AIDS deaths and HIV infection rates. Recent findings indicate that a drug commonly prescribed to treat nail fungus appears to kill HIV in cell cultures.

A new study by an international team of researchers, found that the drugs work against HIV in two ways: by inhibiting expression of certain HIV genes and by jamming up the host cell's mitochondria ‑ the little powerhouses that supply them with energy. Both these effects reactivate the cell's suicide pathway.

The new research reveals that Ciclopirox, an antifungal cream used all over the world, completely eradicates HIV ‑ the virus that leads to AIDS ‑ in cultured cells, and the virus does not return when the treatment stops.

The study also found Deferiprone, a systemic drug used to remove excess iron from the body in people who have beta-thalassaemia major, has the same effect. While previous research has already found Ciclopirox and Deferiprone can stop HIV by inhibiting some of the virus' genes, this new study is the first to show an additional route to reactivation of cell suicide via mitochondrial interference.

Ciclopirox is not approved for systemic use, as it is a topical cream. But the discovery that both drugs, each well-tolerated in humans, are also able to eradicate HIV in cell culture renews hope that HIV and AIDS will one day, in the not-too-distant future, be wiped from the face of the Earth

The researchers, including a team from Rutgers New Jersey Medical School, write about their findings in a paper published online this week in the journal, PLOS ONE.

Because both drugs are reportedly already approved for use in humans both in the US and Europe ‑ an exercise that researchers believe normally lengthens the process ‑ drug development should be less costly and time-consuming, bringing closer the prospect of global elimination of HIV and AIDS.

According to the PLOS ONE report, Ciclopirox allowed HIV-infected cells to get killed off by blocking the cells' mitochondria. In addition, Ciclopirox eliminated HIV from cell cultures, and the virus did not return when the anti-fungal drug was stopped, the study authors said.

The study leaders, Michael Mathews and Hartmut Hanauske-Abel of the Rutgers New Jersey Medical School, were quoted saying that this does not occur with currently available anti-HIV drugs, which must be taken for the rest of a patient's life.

The effectiveness of Ciclopirox against HIV needs to be confirmed in human clinical trials. But because the drug is already approved by the US Food and Drug Administration for treatment of fungal infection and is considered safe, the clinical trial process for this treatment could be quicker and less costly than usual, the researchers said.

The use of combination antiretroviral drugs has vastly improved HIV treatment, the study authors said in a Rutgers news release. These so-called drug cocktails are effective at keeping HIV under control, but they never completely eradicate the infection.

HIV's persistence is partially due to its ability to disable a cell's so-called suicide pathway, which is normally triggered when a cell becomes infected or damaged.

October 2013
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