Inflammation, Immune Activation, and Antiretroviral Therapy in HIV.

Curr HIV/AIDS Rep

School of Health and Rehabilitation Sciences, Division of Medical Laboratory Science, Ohio State University, 535A Atwell Hall, 453 W. 10th Ave, Columbus, OH, 43210, USA.

Published: June 2017

Purpose Of Review: This review focuses on the differential effects of contemporary antiretrovirals on systemic inflammation as heightened immune activation is linked to important co-morbidities and mortality with HIV infection.

Recent Findings: Antiretroviral therapy (ART) reduces dramatically systemic inflammation and immune activation, but not to levels synchronous with HIV-uninfected populations. In one ART initiation trial, integrase inhibitors appear to reduce inflammation to a greater degree than non-nucleoside reverse transcriptase inhibitors (NNRTIs); however, it is not clear that there are beneficial effects on inflammation resulting from treatment with integrase inhibitors compared to PIs, between PIs and NNRTIs, between specific nucleoside reverse transcriptase inhibitors, or with maraviroc in ART-naïve patients. In ART switch studies, changing to an integrase inhibitor from a PI-, NNRTI-, or enfuvirtide-containing regimen has resulted in improvement in several markers of inflammation. Additional research is needed to conclusively state whether there are clear differences in effects of specific antiretrovirals on inflammation and immune activation in HIV.

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Source
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC5514315PMC
http://dx.doi.org/10.1007/s11904-017-0356-xDOI Listing

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