Studies
suggest that chronic inflammation may contribute to the elevated risk of cardiovascular
disease observed in people with HIV, though the underlying mechanisms remain poorly
understood and other factors, including antiretroviral therapy, also play a role.
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Salsalate
Tablet |
As
reported in the March 12, 2008 issue of AIDS, researchers conducted a pilot
study to asses whether treatment with the anti-inflammatory drug salsalate might
improve blood vessel function in HIV positive individuals not on HAART.
Salsalate is a nuclear factor-kappa-beta (NF-kappa-B) inhibitor marketed under
various names including Amigesic, Disalcid, and Salflex.
The
study included 11 HIV positive adult patients with a CD4 cell count above 350
cells/mm3 who were not yet taking combination
antiretroviral therapy. All showed evidence of endothelial dysfunction (reduced
blood vessel diameter) at baseline.
The
researchers found that 1500 mg twice-daily oral salsalate for 8 weeks significantly
improved flow-mediated dilation of the brachial artery in the upper arm, a measure
of endothelial function. Flow-mediated dilation increased by a median of 4.2%
among the 8 participants who completed the study (P = 0.02).
No changes
were observed in HIV viral load or markers of inflammation. However, liver toxicity
-- indicated by abnormal liver function tests -- occurred frequently. Two participants
experienced severe liver dysfunction, which resolved after they stopped taking
salsalate. Two others required salsalate dose reduction due to milder liver enzyme
elevations.
"Our data provide support for the concept that HIV, via
systemic inflammation, may promote atherosclerosis independent of combination
antiretroviral therapy," the study authors concluded. "Research using
alternative agents is warranted to examine the role of inflammation in HIV-related
cardiovascular disease."
04/15/08
Reference
SK
Gupta, RM Johnson, C Saha, and others. Improvement in HIV-related endothelial
dysfunction using the anti-inflammatory agent salsalate: a pilot study. AIDS
22(5): 653-655. March 12, 2008.
