Several recent reports suggest a role of retroviral integrase inhibitors as therapy for herpes virus infections either by effects on a herpes recombinase related to the retroviral integrase [14,15], or by effects on another conserved family of herpes virus proteins termed terminases required for genome cleavage and viral packaging .
Because of the patient's documented elevated titers of IgG to both EBV and other human herpes viruses, she was offered a trial of Raltegravir (Issentress), a retroviral integrase inhibitor with FDA approval for use in HIV-1 infection [17–19].
Remarkably, in contrast to her complete lack of response to acyclovir 2 years previously she experienced a complete remission of all of her symptoms after less than one week of Raltegravir.
Autoimmun Rev.2011 Dec;11(2):88-97. doi: 10.1016/j.autrev.2011.08.005. Epub 2011 Aug 18.
Autoimmune disease: A role for new anti-viral therapies?
Many chronic human diseases may have an underlying autoimmune mechanism. In this review, the author presents a case of autoimmune CIU (chronic idiopathic urticaria) in stable remission after therapy with a retroviral integrase inhibitor, raltegravir (Isentress). Previous reports located using the search terms "autoimmunity" and "anti-viral" and related topics in the pubmed data-base are reviewed suggesting that novel anti-viral agents such as retroviral integrase inhibitors, gene silencing therapies and eventually vaccines may provide new options for anti-viral therapy of autoimmune diseases. Cited epidemiologic and experimental evidence suggests that increased replication of epigenomic viral pathogens such as Epstein-Barr Virus (EBV) in chronic human autoimmune diseases such as rheumatoid arthritis (RA), systemic lupus Erythematosus (SLE), and multiple sclerosis (MS) may activate endogenous human retroviruses (HERV) as a pathologic mechanism. Memory B cells are the reservoir of infection of EBV and also express endogenous retroviruses, thus depletion of memory b-lymphocytes by monoclonal antibodies (Rituximab) may have therapeutic anti-viral effects in addition to effects on B-lymphocyte presentation of both EBV and HERV superantigens. Other novel anti-viral therapies of chronic autoimmune diseases, such as retroviral integrase inhibitors, could be effective, although not without risk.