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February 20, 2020

Can drugs meant for HIV treat the new coronavirus?

Daily Briefing

    Absent a cure for the new coronavirus, the scientific community is exploring whether doctors can treat the disease with medicines used to treat HIV, Ebola, hepatitis C, and other notorious viruses.

    Our analysis: The 'recurring themes' of disease outbreaks

    About the outbreak

    Reports of the new coronavirus first surfaced in early December 2019 in Wuhan, China. According to the World Health Organization (WHO), the main symptoms of the virus, which WHO officially named COVID-19, are fever and lesions in both lungs. Some patients also have reported difficulty breathing, WHO said.

    As of the end of the day Wednesday, officials in China said there were 2,118 reported deaths linked to the virus. A vast majority of the deaths occurred in mainland China. Health officials also reported 74,546 cases of the virus globally, with the vast majority of those cases occurring in China.

    Outside of China, the largest outbreak of the virus cropped up on a cruise ship harbored in Japanese waters, according to CNN. People aboard the ship were quarantined on the vessel after a passenger was found to have the virus. The quarantine ended Wednesday, and more than confirmed cases of the COVID-19 have been link to the boat. Two passengers, both in their 80s, died from the virus.

    Can HIV meds treat the coronavirus?

    On Tuesday, the Japanese government announced it will start clinical trials to test HIV medication as a treatment for COVID-19.

    While no therapy has been proven fully effective against COVID-19, researchers have said HIV drugs hold potential for treating the new coronavirus as previous research has produced strong evidence that the combination treatments used to treat HIV are effective against other coronaviruses, such as SARS and MERS.

    For example, China last month started testing Kaletra, a combination of the HIV drugs lopinavir and ritonavir, to treat COVID-19. Previous studies suggested Kaletra was effective in preventing SARS from maturing and replicating.

    Researchers in China also are exploring other treatments, such as remdesivir, an experimental drug that was tested out as an Ebola treatment. Doctors in the United States used remdesivir to treat an American patient with the new coronavirus after the patient had experienced symptoms for a week. The patient's symptoms began to improve within a day of receiving the drug via an IV, and he was released from the hospital, Kaiser Health News (KHN) reports.

    In addition, the scientific community is eyeing drugs to treat hepatitis C as a potential treatment for the new coronavirus.

    The reason researchers are looking to these medicines is that the new coronavirus—like HIV, Ebola, and hepatitis C—are all RNA viruses. While individual RNA viruses manifest differently in humans, Gizmodo reports that the drugs target weaknesses in RNA viruses. For example, lopinavir inhibits enzymes that allow the virus to infect other cells and replicate and the hepatitis C drug ribavirin can prevent an enzyme, called RNA-dependent RNA polymerase, from reproducing inside a cell.

    Hope is met with skepticism

    But while research has indicated the drugs for other diseases may hold promise for COVID-19, researchers say that there's still much to learn about these drugs' potential.

    Recent outbreaks of other coronaviruses, such as SARS and MERS, were relatively short, which limited researchers' ability to vet treatments in humans, according to KHN. For instance, research in animals suggests remdesivir can slow replication of SARS and MERS coronaviruses, but it's not certain whether the drug will do that against the new coronavirus, according to KHN.

    Stanley Perlman, a professor of microbiology and immunology at the University of Iowa, said, "Just because [a drug] works well in a test tube and in animals doesn't mean that it will work in people."

    In Japan, government spokesperson Yoshihide Suga said officials are making "preparations so that clinical trials using HIV medication on the novel coronavirus can start as soon as possible." He added it was unclear how long it would take for a drug to be approved as a treatment.

    Experts also noted that having a standard treatment for COVID-19 might not ensure the end of the virus outbreak because the majority of COVID-19 cases are mild, so they might not respond to antiviral drugs (Rodriguez, Kaiser Health News/Scientific American, 2/13; Cara, Gizmodo, 2/18; Murakami/Park, Reuters, 2/17; Westcott et al., CNN, 2/19; Shih/Armus, Washington Post, 2/20).

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