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Valproic acid is in Phase 2 development as a latency-reversing agent for HIV.
(Compound details obtained from ChemIDplus Advanced,1 NIAID Therapeutics Database,2 Treatment Action Group website,3 and Depakote ER full prescribing information4)
What is valproic acid?
Valproic acid (brand name: Depakote ER) is a drug that has been approved by the U.S.to treat certain symptoms of bipolar disorder (a type of mental illness), to treat some types of seizures, and to prevent migraine headaches.4,5It is also being studied as an as part of a strategy to cure HIV. As an investigational HIV drug, valproic acid belongs to a group of HIV drugs called .3
How do latency-reversing agents work?
Currently, there is no cure for HIV. One of the main obstacles to curing HIV infection is that the can remain hidden and inactive (latent) inside certain cells of the (such as resting CD4 cells) for many months or even years. The cells where latent HIV hides are known as the . Because HIV in this latent state is inactive, the immune system cannot detect the virus, and the (ARV) drugs that are used to treat HIV have no effect on it.6-8
Latency-reversing agents work by drawing HIV out of its latent state within resting CD4 cells. Once the latent HIV is reactivated, the CD4 cells that harbor the virus are more likely to be recognized and killed by the body’s immune system or may be killed by certain HIV therapies, such as those that can enhance the body’s What is a Latent HIV Reservoir? fact sheet.to HIV. Researchers hope that the combined use of valproic acid and other HIV-fighting strategies, including ongoing (ART), may fully eliminate HIV from the body.6-8 To learn more, see the ClinicalInfo
Which clinical trials are studying valproic acid?
Study Names: CTN-205; NCT00289952
Status: This study has been completed.
Purpose: The purpose of this study was to determine whether valproic acid in combination with ART could reduce the amount of latent HIV in the body.9,10
Study Name: NCT00614458
Status: This study has been completed.
Location: United States
Purpose: The purpose of this study was to determine whether adding valproic acid and the HIV medicine raltegravir to a participant’s current ART regimen could reduce the amount of latent HIV in the body.11,12
Study Names: LUNA; NCT03525730
Status: The recruitment status of this study is unknown.
Purpose: The purpose of this study is to examine whether valproic acid along with pyrimethamine can reactivate latent HIV and reduce the amount of latent HIV in the body.13
For more details on the studies listed above, see the Health Professional version of this drug summary.
What side effects might valproic acid cause?
One goal of HIV research is to identify new drugs that have fewer side effects. The following side effects were observed in some of the studies of valproic acid listed above.
In this Phase 2 study, some participants dropped out because of side effects they had while taking valproic acid. As treatment time on valproic acid increased, the number of participants dropping out of the study increased.14
In this Phase 2 study that looked at adding valproic acid and raltegravir to ART, no significant side effects related to valproic acid were reported.11,12
Because valproic acid is still being studied, information on possible side effects of the drug is not complete. As testing of valproic acid continues, additional information on possible side effects will be gathered.
Additional information on side effects known to be associated with valproic acid can be found in the FDA-approved Full Prescribing Information for valproic acid and the Full Prescribing Information for Depakote ER.4,5
Where can I get more information about clinical trials studying valproic acid?
More information about valproic acid-related research studies is available from the ClinicalInfo database of study summaries. Click on the title of any trial in the list to see the ClinicalTrials.gov trial summary and more information about the study.
Some clinical trials may be looking for volunteer participants. Your health care provider can help you decide whether participating in a NIH Clinical Research Trials and You.is right for you. For more information, visit
- United States National Library of Medicine. ChemIDplus Advanced: valproic acid. https://chem.nlm.nih.gov/chemidplus/rn/99-66-1. Accessed June 12, 2020
- National Institute of Allergy and Infectious Diseases (NIAID). NIAID ChemDB, HIV Drugs in Development. https://chemdb.niaid.nih.gov/DrugDevelopmentHIV.aspx. Accessed June 12, 2020
- Treatment Action Group website. Research toward a cure trials. http://www.treatmentactiongroup.org/cure/trials. Accessed June 12, 2020
- AbbVie Inc. Depakote ER: full prescribing information, May 27, 2020. DailyMed. https://dailymed.nlm.nih.gov/dailymed/drugInfo.cfm?setid = 0dc024ce-efc8-4690-7cb5-639c728fccac. Accessed June 12, 2020
- Bionpharma Inc. Valproic acid capsules: full prescribing information, March 5, 2019. DailyMed. https://dailymed.nlm.nih.gov/dailymed/drugInfo.cfm?setid = ceb52870-76d0-4108-a1d4-ba7096fbacdd. Accessed June 12, 2020
- Siliciano RF, Greene WC. HIV latency. Cold Spring Harb Perspect Med. 2011;1(1):a007096.
- Rasmussen TA, Tolstrup M, Winckelmann A, Østergaard L, Søgaard OS. Eliminating the latent HIV reservoir by reactivation strategies. Hum Vaccines Immunother. 2013;9(4):790–799.
- National Institute of Allergy and Infectious Diseases (NIAID). HIV viral eradication. https://www.niaid.nih.gov/diseases-conditions/hiv-viral-eradication. Accessed June 12, 2020
- McGill University Health Center. Use of valproic acid to purge HIV from resting CD4 memory cells: a proof-of-concept study. In: ClinicalTrials.gov. Bethesda (MD): National Library of Medicine (US). Registered on February 8, 2006. NLM Identifier: NCT00289952. https://clinicaltrials.gov/ct2/show/NCT00289952. Accessed June 12, 2020
- Routy JP, Tremblay CL, Angel JB, et al. Valproic acid in association with highly active antiretroviral therapy for reducing systemic HIV-1 reservoirs: results from a multicentre randomized clinical study. HIV Med. 13(5):291-296.
- University of North Carolina, Chapel Hill. 10493 - MK-0518 intensification and HDAC inhibition in depletion of resting CD4 T cell HIV infection. In: ClinicalTrials.gov. Bethesda (MD): National Library of Medicine (US). Registered on January 31, 2008. NLM Identifier: NCT00614458. https://clinicaltrials.gov/ct2/show/NCT00614458. Accessed June 12, 2020
- Archin NM, Cheema M, Parker D, et al. Antiretroviral intensification and valproic acid lack sustained effect on residual HIV-1 viremia or resting CD4 cell infection. PLoS ONE. 2010;5(2). https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2826423/. Accessed June 12, 2020
- Erasmus Medical Center. LRAs united as a novel anti-HIV strategy (LUNA): a randomized controlled trial. In: ClinicalTrials.gov. Bethesda (MD): National Library of Medicine (US). Registered on April 23, 2018. NLM Identifier: NCT03525730. https://clinicaltrials.gov/ct2/show/NCT03525730. Accessed June 12, 2020
- Routy J, Angel J, Spaans J, et al. Design and implementation of a randomized crossover study of valproic acid and antiretroviral therapy to reduce the HIV reservoir. HIV Clin Trials. 2012;13(6). https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3815453/. Accessed June 12, 2020
Last Reviewed: June 12, 2020