
    a re-evaluation of research risks to participants were greater than originally anticipated
  
['hiv infections']
['disulfiram, (national drug code) ndc 0378-4141-01', 'vorinostat, ndc 00006-0568-40']

        Inclusion Criteria:

          -  Age 18-65 years with documented HIV-1 infection (antibody positive or detectable
             plasma HIV-1 RNA)

          -  Receiving combination ART with plasma HIV RNA <50 copies/mL for >3 years

          -  CD4+ T cell count >350 microliter at screening

          -  Able to provide informed consent

          -  Willing to abstain from alcohol consumption from one day before to 14 days after
             completing 28 days of disulfiram

          -  One month post influenza vaccine (from screening visit)

          -  Women of non-child-bearing potential defined as > 12 months of spontaneous amenorrhea
             and ≥ 45 years of age, or documented medical history of one of the following:
             hysterectomy, bilateral oophorectomy or tubal ligation.

          -  Women of Child Bearing Potential (WOCBP) with a negative pregnancy test at Screening
             and agrees to use one of the study protocol specified methods of contraception to
             avoid pregnancy

        Exclusion Criteria:

          -  Current alcohol use disorder or hazardous alcohol use (>7 drinks per week for women or
             > 14 drinks per week for men) as determined by clinical evaluation

          -  Current or recent (in the last 4 days) use of metronidazole or any drug formulation
             that contains alcohol or that might contain alcohol, including the gelatin capsule and
             liquid formulations of ritonavir, ritonavir/lopinavir, amprenavir and fosamprenavir,
             and alcohol-containing preparations such as cough syrups, tonics etc.

          -  Current use of tipranavir or Maraviroc

          -  Current use of zidovudine, stavudine or didanosine (as disulfiram potentially has
             potent irreversible inhibitory effects on mitochondrial metabolism and hence could
             exacerbate the toxicity of these drugs)

          -  Concurrent use of rivaroxaban (a CYP3A metabolized medication) as the cytochrome P450
             inhibitory effects of disulfiram on rivaroxaban are unknown

          -  Current use of warfarin

          -  Individuals who intend to modify antiretroviral therapy during the study period for
             any reason

          -  Significant myocardial disease (current myocarditis or reduced left ventricular
             ejection fraction below the lower limit of normal) or diagnosed coronary artery
             disease

          -  Significant renal disease (eGFR <50 milliliter/minute)

          -  History of psychosis, seizure disorder, abnormal electroencephalogram or brain damage
             with significant persisting neurological deficit

          -  Prior malignancy active within the previous 3 years except for local curable cancers
             that have been apparently cured, such as basal or squamous cell skin cancer,
             superficial bladder cancer or carcinoma in situ of the prostate, cervix or breast.

          -  Known hypersensitivity to disulfiram or vorinostat or contraindications to treatment
             with these agents

          -  Participation in another latency reversal study or receipt of vorinostat or disulfiram
             in the previous 12 months before starting the investigational treatment

          -  Any significant acute medical illness requiring hospitalization within preceding 8
             weeks

          -  Hepatitis B (HBV) or hepatitis C (HCV) co-infection as determined by detection of
             HBsAg or HCV RNA (Individuals with prior hepatitis infection that is now cleared are
             eligible for enrolment)

          -  Receipt of immunomodulating agents (excluding immunization) or systemic
             chemotherapeutic agents within 28 days prior to study entry

          -  Current or recent gastrointestinal disease or surgery that may impact the absorption
             of the investigational drug

          -  Active substance use that in the opinion of the investigator will prevent adequate
             compliance with study procedures

          -  Women who are currently pregnant or breastfeeding

          -  Women of Child Bearing Potential (WOCBP) who are unwilling or unable to use an
             acceptable method of contraception to avoid pregnancy

          -  Unable or unwilling to adhere to protocol procedures

          -  The following laboratory values within 6 weeks before starting the investigational
             drug (lab tests may be repeated to obtain acceptable values before failure at
             screening is concluded)

               -  Hepatic transaminases (AST or ALT) ≥3 x upper limit of normal (ULN)

               -  Serum total bilirubin ≥1.5 x ULN

               -  eGFR <50 milliliter/min

               -  Hemoglobin <11.0 g/deciliter

               -  Platelet count ≤100 x10^9/L (liter)

               -  Absolute neutrophil count ≤1.5x10^9/L

               -  Serum potassium, magnesium, phosphorus outside normal limits

               -  Total calcium (corrected for serum albumin) or ionized calcium ≤ lower normal
                  limits
      