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An alternating  copolymer of styrene and maleic acid  (alt-PSMA) differs from other  polyanionic antiviral agents in that the  negative charges of alt-PSMA  are provided by carboxylic acid groups instead  of sulfate or sulfonate moieties. We  hypothesized that alt-PSMA  would have activity against human  immunodeficiency virus type 1 (HIV-1) comparable  to other polyanions, such as the related  compound, poly(sodium 4-styrene sulfonate)  (PSS). In assays using cell lines and primary  immune cells, alt-PSMA was  characterized by low cytotoxicity and effective  inhibition of infection by HIV-1 BaL and IIIB as  well as clinical isolates of subtypes A, B, and  C. In mechanism of action assays, in which each  compound was added to cells and subsequently  removed prior to HIV-1 infection  (&#8220;washout&#8221; assay),  alt-PSMA caused no enhancement  of infection, while PSS washout increased  infection 70&#x0025; above control levels. These  studies demonstrate that  alt-PSMA is an effective HIV-1  inhibitor with properties that warrant further  investigation

A Styrene-alt-Maleic Acid Copolymer Is an Effective Inhibitor of R5 and X4 Human Immunodeficiency Virus Type 1 Infection