Antiretroviral therapy inadequate against arterial inflammation




Combined antiretroviral therapy (ART) significantly reduced viral load from 4.3 copies/mL to 1.3 copies/mL in a study of a dozen treatment-naive HIV-infected adults after 6 months. However, arterial inflammation, as measured by aortic target-background ratio (TBR), did not improve significantly, wrote Dr. Markella V. Zanni of Harvard Medical School, Boston, and colleagues.

The patients received a combination regimen including elvitegravir, cobicistat, emtricitabine, and tenofovir disoproxil fumarate. Arterial inflammation was assessed via fludeoxyglucose F 18 positron emission tomography.

The findings affirm the overall benefits of ART, but suggest that ART alone may not be enough to prevent cardiovascular disease in HIV patients in the short term, the researchers wrote.

“Complementary strategies to further improve immune activation indices and arterial inflammation – including statins and other immunomodulatory strategies – may be needed in addition to ART,” the researchers noted. “Future studies are needed to elucidate the relationship between arterial inflammation, atherogenesis, and myocardial infarction in HIV,” they added (JAMA Cardiol. 2016 May 25. doi: 10.1001/jamacardio.2016.0846). Read the study here.

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