On the use of chloroquine for chikungunya
Authors: Andrea Savarino, Roberto Cauda, Antonio Cassone
Journal: The Lancet Infectious Diseases (2007)

In their Review on chikungunya, Gilles Pialoux and colleagues1Pialoux G Gaüzère BA Jauréguiberry S Strobel M Chikungunya, an epidemic arbovirosis.Lancet Infect Dis. 2007; 7: 319-327Summary Full Text Full Text PDF PubMed Scopus (810) Google Scholar quote a Reflection and Reaction commentary previously published by our group2Savarino A Di Trani L Donatelli I Cauda R Cassone A New insights into the antiviral effects of chloroquine.Lancet Infect Dis. 2006; 6: 67-69Summary Full Text Full Text PDF PubMed Scopus (457) Google Scholar as the source for the statement that "a clinical trial in South Africa failed to confirm the clinical efficacy of chloroquine on arthralgia". It is true that chloroquine displays antiviral and anti-inflammatory properties that, in our opinion, merit testing in the clinical management of some viral diseases. However, we reported no data on chikungunya, nor did we mention this disease in our articles in The Lancet Infectious Diseases.2Savarino A Di Trani L Donatelli I Cauda R Cassone A New insights into the antiviral effects of chloroquine.Lancet Infect Dis. 2006; 6: 67-69Summary Full Text Full Text PDF PubMed Scopus (457) Google Scholar, 3Savarino A Boelaert JR Cassone A Majori G Cauda R Effects of chloroquine on viral infections: an old drug against today's diseases.Lancet Infect Dis. 2003; 3: 722-727Summary Full Text Full Text PDF PubMed Scopus (975) Google Scholar Our research has so far been focused on the effects of chloroquine on HIV-1,4Savarino A Lucia MB Rastrelli E et al.Anti-HIV effects of chloroquine: inhibition of viral particle glycosylation and synergism with protease inhibitors.J Acquir Immune Defic Syndr. 2004; 35: 223-232Crossref PubMed Scopus (111) Google Scholar severe acute respiratory syndrome coronavirus,3Savarino A Boelaert JR Cassone A Majori G Cauda R Effects of chloroquine on viral infections: an old drug against today's diseases.Lancet Infect Dis. 2003; 3: 722-727Summary Full Text Full Text PDF PubMed Scopus (975) Google Scholar influenza A viruses,5Di Trani L Savarino A Campitelli L et al.Different pH requirements are associated with divergent inhibitory effects of chloroquine on human and avian influenza A viruses.Virol J. 2007; 4: 39Crossref PubMed Scopus (64) Google Scholar and cancer cells.6Savarino A Lucia MB Giordano F Cauda R Risks and benefits of chloroquine use in anticancer strategies.Lancet Oncol. 2006; 7: 792-793Summary Full Text Full Text PDF PubMed Scopus (45) Google Scholar It is our policy to suggest new ideas only when they are supported by robust experimental results, which are highly reproducible in different laboratory settings.7Naarding MA Baan E Pollakis G Paxton WA Effect of chloroquine on reducing HIV-1 replication in vitro and the DC-SIGN mediated transfer of virus to CD4+ T-lymphocytes.Retrovirology. 2007; 4: 6Crossref PubMed Scopus (52) Google Scholar, 8Keyaerts E Vijgen L Maes P Neyts J Van Ranst M In vitro inhibition of severe acute respiratory syndrome coronavirus by chloroquine.Biochem Biophys Res Commun. 2004; 323: 264-268Crossref PubMed Scopus (525) Google Scholar, 9Ooi EE Chew JS Loh JP Chua RC In vitro inhibition of human influenza A virus replication by chloroquine.Virol J. 2006; 3: 39Crossref PubMed Scopus (128) Google Scholar, 10Sundberg AL Steffen AC Enhancing the effect of radionuclide tumor targeting, using lysosomotropic weak bases.Int J Radiat Oncol Biol Phys. 2007; 67: 279-287Summary Full Text Full Text PDF PubMed Scopus (8) Google Scholar Furthermore, clinical trials in Réunion on chloroquine as a potential antiviral for chikungunya cannot be linked to our previous studies, in that the chloroquine dosage adopted (ie, 250 mg daily)11The ClinicalTrials.Gov database. CuraChik: a trial of the efficacy and safety of chloroquine as therapeutic treatment of chikungunya disease http://clinicaltrials.gov/ct/show/NCT00391313;jsessionid=F91ADE5077910A5240B7AA9AA7666FA8?order=1 (accessed Aug 9, 2007).Google Scholar is inconsistent with the tissue drug concentrations that we report are necessary to inhibit the aforementioned viruses.2Savarino A Di Trani L Donatelli I Cauda R Cassone A New insights into the antiviral effects of chloroquine.Lancet Infect Dis. 2006; 6: 67-69Summary Full Text Full Text PDF PubMed Scopus (457) Google Scholar, 12Savarino A Lucia MB ter Heine R et al.Quinoline antimalarials as investigational drugs for HIV-1/AIDS: in vitro effects on HIV-1 replication, HIV-1 response to antiretroviral drugs, and intracellular antiretroviral drug concentrations.Drug Dev Res. 2006; 67: 806-817Crossref Scopus (10) Google Scholar We declare that we have no conflicts of interest.