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Treating Chikungunya using HIV/AIDS drug efavirenz

1 min read
All exams GA

Efavirenz is a non-nucleoside inhibitor used for HIV/AIDS treatment.

  • New Study
    • Preliminary research suggests it could be repurposed for chikungunya treatment.
  • Current Scenario
    • No approved antiviral drugs exist for chikungunya, only a few have been tested in animal models.

Chikungunya in India

Chikungunya is a mosquito-borne viral disease characterized by fever and severe joint pain, transmitted by infected mosquitoes like Aedes aegypti and Aedes albopictus. 

  • Cause:Chikungunya is caused by a virus belonging to the alphavirus genus of the family Togaviridae. 
  • Re-emergence in 2006 after 20-30 years.
  • 2006 Outbreak
    • 14 million suspected cases, with 2,001 lab-confirmed cases.
  • Decline until 2014, followed by a rise in cases from 2018 onwards.

Study Findings (IIT Roorkee Research)

  • Conducted by Department of Biosciences and Bioengineering, IIT Roorkee.
  • Published in: ACS Infectious Diseases.

A. In-vitro (Cell Line) Studies

  • Tested on Vero cells and human hepatic cell lines (as chikungunya affects liver hepatocytes).
  • Results:
    • Efavirenz inhibited virus replication by 99% at low micromolar concentrations.
    • Drug was effective up to 6-8 hours post-infection, acting in the early replication phase.

B. In-vivo (Mouse Model) Studies

  • Efavirenz treatment significantly reduced viral load in chikungunya-infected mice.
  • Unexpected Finding:
    • Increased swelling in the limbs due to the drug’s pro-inflammatory action.
    • Despite this, viral propagation was controlled.
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  • Anecdotal case of a 43-year-old HIV patient receiving efavirenz showed improvement in chikungunya symptoms.
  • Improvement not solely attributed to efavirenz but aligns with anti-chikungunya activity observed in lab studies.

4. Potential and Future Steps

  • Efavirenz shows strong promise due to:
    • Good pharmacokinetics (effective drug absorption and metabolism).
    • Proven safety and efficacy in HIV treatment.
    • Demonstrated ability to suppress chikungunya virus replication.
  • Next Steps:
    • Clinical trials to assess efavirenz’s effectiveness and safety in humans for chikungunya treatment.

Source: TH