mDAPTA, a potent CCR5 receptor blocker, prevents viral recovery from CD8-depleted patient PBMCs with VL< 50 background

Elimination of the treatment resistant persistent viral reservoir is an important treatment goal. Monitoring the size and replicative-competence of HIV reservoirs has been indicated as a means for measuring the efficacy of drug treatments. An enhanced culture method using stimulation of CD8-depleted PBMCs produces an effective means by which virus can be cultured from Clinically Relevant Cellular Compartment (CRCC). We have shown that, monomeric D-Ala-Peptide-T-amide (mDAPTA), an R5 entry inhibitor eliminated persistent monocyte infection in 11 patients. This study reports a novel finding that mDAPTA prevents HIV recovery and production of replication-competent HIV from CD8-depleted patient PBMCs.
Methods: CD8-depleted PBMCs were isolated from HIV-negative and positive donors with VL< 50 RNA. PBMCs were then subjected to virus rescue using activation by anti-CD28/CD3 in presence or absence of CCR5 inhibitors DAPTA and Maraviroc. Virus was quantitated using TZMbl as reporter cells and by p24 assays.
Results: Replication competent virus (R5 and X4) was generated in 4 HIV patients CD8-depleted PBMCs when no drug was added to the cultures. Interestingly, we found that DAPTA (0.1pm) completely inhibited the release of virus (X4 and R5) from PBMCs from all patients in vitro. DAPTA's effect on inhibiting X4 replication was primarily via modulating activation. Maraviroc only worked at the level of virus entry. DAPTA was 1000 times more potent than maraviroc in inhibiting virus entry. Currently we are investigating the virological outcome to detect infectious virus with mDAPTA in a large cohort of infected individuals.
Conclusions: Our findings demonstrate strongly that mDAPTA prevents viral rebound/recovery from CD8-depleted patient PBMCs by blocking CCR5 entry and cellular activation thus preventing virus release from CRCC. Moreover patients with X4 viruses that fail to show significant virological benefit after receiving CCR5-inhibitors which primarily target CCR5 may benefit from DAPTA treatment. Thus DAPTA is an effective blocker of virus release and cellular activation.

L. Agrawal1, O. Ducoudret1, N. Baichoo1, M. Laznicka2, M. Ruff1, C. Pert1
1Rapid Laboratories, Rockville, United States, 2Rapid Pharmaceuticals, Rigistrasse, Switzerland