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Recombinant soluble CD4 (rsCD4) is a biologic therapeutic agent developed for the treatment of HIV-1 infection. It consists of the extracellular domain of the human CD4 receptor, which serves as the primary entry point for HIV-1 into host cells. The drug functions as a molecular decoy by binding to the HIV-1 envelope glycoprotein gp120, thereby preventing the virus from attaching to and infecting CD4+ T lymphocytes. Developed and tested by the National Institute of Allergy and Infectious Diseases (NIAID) and the AIDS Clinical Trials Group (ACTG), rsCD4 was evaluated in Phase I and Phase II clinical trials both as a monotherapy and in combination with zidovudine (AZT). While the agent was well-tolerated and showed antiviral activity against laboratory-adapted strains of HIV-1, its clinical development was ultimately discontinued due to its limited efficacy against primary clinical isolates and its short half-life in the bloodstream.
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