Chloroquine (Avloclor / Malarivon / Nivaquine)

Chloroquine (Avloclor / Malarivon / Nivaquine) is an anti-malaria drug, which some experts have advocated as a low-cost treatment for HIV for use in developing countries.

Chloroquine is available as a generic formulation, or as Avloclor (AstraZeneca) and Nivaquine (Beacon).

Chloroquine may cause gastrointestinal problems, headache, convulsions, visual disturbances, loss of pigmentation, hair loss and rash. People with pre-existing liver or kidney damage should use the drug with caution. Bone marrow suppression is a rare side-effect of chloroquine which may have implications for its use in people with HIV, particularly those taking AZT (zidovudine, Retrovir), which can have the same side-effect.

Chloroquine may also have modest ant-HIV activity. It is thought to work against HIV by interfering with gp120 on the surface of HIV, inhibiting the maturation of new virus particles. It reduces the infectivity of new viruses and inhibits the ability of infected cells to clump together.1

Chloroquine can enhance the activity of other anti-HIV drugs, including nucleoside reverse transcriptase inhibitors (NRTIs) and protease inhibitors, by reducing the activity of drug transporters, molecules in the cell membrane that pump drugs out of cells, such as poly-glycoprotein.2

Test-tube studies have also shown that the combination of chloroquine also enhances the anti-HIV activity of hydroxycarbamide (Hydrea) and ddI (didanosine, Videx / VidexEC), while two short-term studies of chloroquine have found that it reduces viral load to a similar degree to AZT monotherapy.3 4 5 A three-year study of the combination of chloroquine, hydroxycarbamide and ddI in HIV-positive patients has found it to be effective in reducing viral loads, possibly enabling the start of antiretroviral therapy to be delayed in resource-limited settings.6

Chloroquine use is also linked to reduced HIV viral loads in breastmilk, potentially reducing the risk of HIV transmission through breastfeeding.7

References

  1. Savarino A et al. Anti-HIV effects of chloroquine: mechanisms of inhibition and spectrum of activity. AIDS 15: 2221-2229, 2001
  2. Savarino A et al. Anti-HIV effects of chloroquine: inhibition of viral particle glycosylation and synergism with protease inhibitors. Eleventh Conference on Retroviruses and Opportunistic Infections, San Francisco, abstract 543, 2004
  3. Boelaert JR et al. Chloroquine exerts an additive in vitro anti-HIV type 1 effect when associated with didanosine and hydroxyurea. AIDS Res Hum Retroviruses 15: 1241-1247, 1999
  4. Boelaert JR et al. The additive in vitro anti-HIV-1 effect of chloroquine, when combined with zidovudine and hydroxyurea. Biochem Pharmacol 61: 1531-1535, 2001
  5. Sperber K et al. Comparison of hydroxychloroquine with zidovudine in asymptomatic patients infected with human immunodeficiency virus type 1. Clin Ther 19: 913-923, 1997
  6. Paton NI et al. Hydroxychloroquine, hydroxyurea and didanosine as initial therapy for HIV-infected patients with low viral load: safety, efficacy and resistance profile after 144 weeks. HIV Med 6: 13-20, 2005
  7. Semrau K et al. Impact of chloroquine on viral load in breast milk. Trop Med Int Health 11: 800-803, 2006

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Community Consensus Statement on Access to HIV Treatment and its Use for Prevention

Together, we can make it happen

We can end HIV soon if people have equal access to HIV drugs as treatment and as PrEP, and have free choice over whether to take them.

Launched today, the Community Consensus Statement is a basic set of principles aimed at making sure that happens.

The Community Consensus Statement is a joint initiative of AVAC, EATG, MSMGF, GNP+, HIV i-Base, the International HIV/AIDS Alliance, ITPC and NAM/aidsmap
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This content was checked for accuracy at the time it was written. It may have been superseded by more recent developments. NAM recommends checking whether this is the most current information when making decisions that may affect your health.

NAM’s information is intended to support, rather than replace, consultation with a healthcare professional. Talk to your doctor or another member of your healthcare team for advice tailored to your situation.