Antiretroviral therapy and HIV-associated cancers: Antiangiogenic effect of efavirenz on chick chorioallantoic membrane

Purpose: To investigate the anti-angiogenic effect of efavirenz in chick chorioallantoic membrane (CAM).Methods: Fertile eggs of the domestic fowl (Gallus gallus, variant Domesticus) were used as the in vivo vascular test environment. Experimental groups were VEGF, thalidomide (negative control), efavirenz (test drug), control 1 (treated with diluent) and control 2 (no treatment). CAM photographs were taken using a microscope camera. CAM blood vessels were scored as either “present” or “absent”.Results: There was association between treatment drugs and growth of CAM blood vessels (p < 0.05) as follows: control 1 – 100 %, control 2 – 67 %, VEGF - 83 %, thalidomide - 17 %, and efavirenz - 0 % (n = 30). Although efavirenz had absolute anti-angiogenicity and presented as a potential anti-cancer drug, there was no significant difference between the anti-angiogenicity of efavirenz (100 %) and thalidomide (83 %) (F = 1.000, p = 0.341).Conclusion: Being a first-line drug in both HAART and combination treatment of HIV-1, efavirenz may be responsible for spontaneous resolution of secondary cancers in HIV-infected patients on HAART regimen.Keywords: Efavirenz, HIV, Cancers, Angiogenesis, Chick chorioallantoic membrane