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    Antiviral Res. 2009 Jul;83(1):86-9. Epub 2009 Mar 9.

    Rapamycin enhances aplaviroc anti-HIV activity: implications for the clinical development of novel CCR5 antagonists.

    Latinovic O, Heredia A, Gallo RC, Reitz M, Le N, Redfield RR.

    Institute of Human Virology, University of Maryland School of Medicine, Baltimore, MD 21201, USA.

    Maraviroc, the only CCR5 antagonist HIV inhibitor currently approved, has potent antiviral activity in treatment-experienced individuals infected with CCR5-using HIV-1 (R5 HIV-1). However, recent data from the MOTIVATE trials indicate that R5 HIV-1 can develop resistance to Maraviroc, underscoring the need for additional CCR5 antagonists. The CCR5 antagonist aplaviroc (APL) is active against Maraviroc-resistant viral strains but its clinical development has ended because of dose-related toxicity. Here we demonstrate that reduction of CCR5 density (receptors/cell) with the immunomodulatory drug rapamycin (RAPA) enhances the antiviral activity of APL, allowing lower, non-toxic effective doses. In the presence of RAPA, the concentration of APL required for 90% inhibition of R5 HIV-1 in primary CD4 lymphocytes was reduced by as much as 25-fold. We conclude that low doses of RAPA may reduce the anti-HIV effective dose of APL-derivatives currently in development and thus minimize their potential toxicity. Combinations of RAPA and CCR5 antagonists could provide an effective means to control drug-resistant R5 HIV in patients, most notably those infected with Maraviroc-resistant viruses.

    PMID: 19501260 [PubMed - indexed for MEDLINE]

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