Robinson Barry, Turchan Jadwiga, Anderson Caroline, Chauhan Ashok, Nath Avindra
Department of Neurology, Johns Hopkins University, Baltimore, Maryland 21287, USA.
J Neurovirol. 2006 Feb;12(1):1-4. doi: 10.1080/13550280500516278.
Patients with human immunodeficiency virus (HIV) infection often require treatment with anticonvulsants either for treatment of seizures or occasionally for pain control. In this study, the authors determined if the anticonvulsants phenytoin, carbamazepine, and valproate could modulate HIV replication. These drugs activated HIV replication in latently infected monocytic cells but not in latently infected lymphocytic cells at clinically relevant dosages. The activation in the monocytic cells was as a result of transactivation of HIV long terminal repeat (LTR) and could be seen at therapeutic dosages whereas no effect was seen on LTR activation in lymphocytic cells. When the drugs were used in conjunction with known transactivators of HIV LTR such as Tat and phorbol-12-myristate-13-acetate (PMA), no additive or synergistic effect was noted. Although the clinical relevance of these observations needs to be determined, these observations may suggest that monitoring of cerebrospinal fluid (CSF) viral load maybe needed in HIV-infected patients treated with anticonvulsants, because HIV-infected macrophages are important in mediating HIV dementia.
感染人类免疫缺陷病毒（HIV）的患者常常需要使用抗惊厥药来治疗癫痫发作，偶尔也用于控制疼痛。在本研究中，作者确定了抗惊厥药苯妥英、卡马西平和丙戊酸盐是否能调节HIV复制。在临床相关剂量下，这些药物可激活潜伏感染的单核细胞中的HIV复制，但不能激活潜伏感染的淋巴细胞中的HIV复制。单核细胞中的激活是HIV长末端重复序列（LTR）反式激活的结果，在治疗剂量下即可观察到，而对淋巴细胞中的LTR激活没有影响。当这些药物与已知的HIV LTR反式激活剂如Tat和佛波醇-12-肉豆蔻酸酯-13-乙酸酯（PMA）联合使用时，未观察到相加或协同作用。尽管这些观察结果的临床相关性有待确定，但这些观察结果可能提示，在接受抗惊厥药治疗的HIV感染患者中，可能需要监测脑脊液（CSF）病毒载量，因为HIV感染的巨噬细胞在介导HIV痴呆中起重要作用。
