Department of Clinical Pharmacy, School of Pharmacy, Mashhad University of Medical Sciences , Mashhad, Iran.
Expert Rev Anti Infect Ther. 2020 Nov;18(11):1119-1133. doi: 10.1080/14787210.2020.1792291. Epub 2020 Jul 13.
Chloroquine (CQ) and hydroxychloroquine (HCQ) originally were prescribed for prevention or treatment of malaria, but now successfully are used in several rheumatologic diseases. In addition, in recent decades considering their immunomodulatory effects, high tolerably, and low cost, they are evaluated for various viral infections from HIV to COVID-19.
In this review, we tried to summarize all available studies on HCQ and CQ efficacy for management of viral infections and the probable mechanisms of action. The data were collected by searching 'Hydroxychloroquine,' 'Chloroquine,' 'Viral infection,' and names of various viral infections in PubMed/MEDLINE, Scopus, and Google Scholar databases from commencement to June 2020. Out of 95 search results, 74 most relevant works were gathered.
HCQ/CQ showed acceptable efficacy in HIV especially as an adjuvant treatment beside routine HAART. However, for some viral infections such as ZIKA, EBOLA, SARS-CoV, and MERS-CoV, human studies are lacking. In the COVID-19 pandemic, in vitro and preliminary human studies showed encouraging findings. However, later well-designed trials and retrospective studies with large sample size not only reported non-significant efficacy but also showed more cardiac adverse reactions. Alkalinization of acid vesicles is the most important mechanism of action.
氯喹（CQ）和羟氯喹（HCQ）最初用于预防或治疗疟疾，但现在已成功用于多种风湿性疾病。此外，近几十年来，由于其具有免疫调节作用、高耐受性和低成本，它们被评估用于从 HIV 到 COVID-19 的各种病毒感染。
在这篇综述中，我们试图总结所有关于 HCQ 和 CQ 治疗病毒感染的有效性及其可能的作用机制的可用研究。数据通过在 PubMed/MEDLINE、Scopus 和 Google Scholar 数据库中搜索“Hydroxychloroquine”、“Chloroquine”、“Viral infection”和各种病毒感染的名称来收集，检索时间从开始到 2020 年 6 月。在 95 个搜索结果中，收集了 74 篇最相关的文献。
HCQ/CQ 在 HIV 中显示出可接受的疗效，特别是作为常规 HAART 治疗的辅助治疗。然而，对于某些病毒感染，如寨卡病毒、埃博拉病毒、SARS-CoV 和 MERS-CoV，缺乏人体研究。在 COVID-19 大流行期间，体外和初步人体研究显示出令人鼓舞的结果。然而，后来设计良好的试验和大样本量的回顾性研究不仅报告了非显著疗效，而且还显示出更多的心脏不良反应。酸化囊泡的碱化是最重要的作用机制。
