31 May HIV Treatment Does Not Reduce Cardiovascular Risk of HIV Infection

Posted at 20:58h in Abuse and Neglect, Author Interviews, Heart Disease, HIV, JAMA by

MedicalResearch.com Interview with:

Steven Grinspoon, MD Professor of Medicine, Harvard Medical School MGH Endowed Chair in Neuroendocrinology and Metabolism Director, MGH Program in Nutritional Metabolism and Nutrition Obesity Research Center at Harvard MGH Boston, MA 02114

Dr. Steven Kyle Grinspoon

Steven Grinspoon, MD
Professor of Medicine, Harvard Medical School
MGH Endowed Chair in Neuroendocrinology and Metabolism
Director, MGH Program in Nutritional Metabolism
and Nutrition Obesity Research Center at Harvard
MGH
Boston, MA 02114

MedicalResearch.com: What is the background for this study? What are the main findings?

Dr. Grinspoon: Numerous epidemiologic studies have shown that people living with HIV face a 1.5 to 2-fold increased risk of heart attack, or myocardial infarction, as compared to individuals without the virus. Mechanisms underlying the increased risk of myocardial infarction in HIV are incompletely understood. It is possible that among people living with HIV, increased systemic immune activation fuels arterial inflammation. Arterial inflammation may, in turn, promote the development of high-risk morphology coronary atherosclerotic plaque, which is liable to rupture and result in myocardial infarction.

For people diagnosed with HIV, the overall health benefits of immediate antiretroviral therapy (ART) are clear. However, the effects of newly-initiated antiretroviral therapy on arterial inflammation have not previously been studied. In this study, we set out to assess among a cohort of treatment-naive HIV-infected subjects, the effects of newly-initiated ART with a contemporary regimen on both immune function and arterial inflammation. We found that among treatment-naive HIV-infected individuals without clinical cardiovascular disease, newly initiated combined antiretroviral therapy has discordant effects to restore immune function without reducing the degree of arterial inflammation.

MedicalResearch.com: What should readers take away from your report?

Dr. Grinspoon: Our findings suggest that additional strategies geared toward reducing arterial inflammation among ART-treated HIV-infected individuals may be needed to help lower the risk of cardiovascular disease.

MedicalResearch.com: What recommendations do you have for future research as a result of this study?

Dr. Grinspoon: Additional research is needed to elucidate relationships between systemic immune activation, arterial inflammation, and atherogenesis/plaque remodeling in HIV. Immune modulatory strategies administered in conjunction with ART will need to be tested for their ability to decrease arterial inflammation, stabilize coronary atherosclerotic plaque, and reduce the risk of heart disease.

MedicalResearch.com: Thank you for your contribution to the MedicalResearch.com community.

Citation:

Zanni MV, Toribio M, Robbins GK, et al. Effects of Antiretroviral Therapy on Immune Function and Arterial Inflammation in Treatment-Naive Patients With Human Immunodeficiency Virus Infection. JAMA Cardiol. Published online May 25, 2016. doi:10.1001/jamacardio.2016.0846.

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Last Updated on May 31, 2016 by Marie Benz MD FAAD

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