Sequential treatment with 5-aza-2'-deoxycytidine and deacetylase inhibitors reactivates HIV-1

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Bouchat, Sophie | Delacourt, Nadège | Kula, Anna | Darcis, Gilles | van Driessche, Benoit | Corazza, Francis | Gatot, Jean-Stéphane | Melard, Adeline | Vanhulle, Caroline | Kabeya, Kabamba | Pardons, Marion | Avettand-Fenoel, Véronique | Clumeck, Nathan | de Wit, Stéphane | Rohr, Olivier | Rouzioux, Christine | van Lint, Carine

Edité par CCSD ; Wiley Open Access -

Reactivation of HIV gene expression in latently infected cells together with an efficient cART has been proposed as an adjuvant therapy aimed at eliminating/decreasing the reservoir size. Results from HIV clinical trials using deacetylase inhibitors (HDACIs) question the efficiency of these latency-reversing agents (LRAs) used alone and underline the need to evaluate other LRAs in combination with HDACIs. Here, we evaluated the therapeutic potential of a demethylating agent (5-AzadC) in combination with clinically tolerable HDACIs in reactivating HIV-1 from latency first in vitro and next ex vivo. We showed that a sequential treatment with 5-AzadC and HDACIs was more effective than the corresponding simultaneous treatment both in vitro and ex vivo. Interestingly, only two of the sequential LRA combinatory treatments tested induced HIV-1 particle recovery in a higher manner than the drugs alone ex vivo and at concentrations lower than the human tolerable plasmatic concentrations. Taken together, our data reveal the benefit of using combinations of 5-AzadC with an HDACI and, for the first time, the importance of treatment time schedule for LRA combinations in order to reactivate HIV.

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