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Inflammation, Immune Activation, and Antiretroviral Therapy in HIV

  • HIV Pathogenesis and Treatment (AL Landay and N Utay, Section Editors)
  • Published:
Current HIV/AIDS Reports Aims and scope Submit manuscript

Abstract

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.

Summary

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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Acknowledgements

This manuscript was supported by the National Institutes of Health.

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Authors and Affiliations

  1. Case Western Reserve University School of Medicine, 10900 Euclid Ave, Cleveland, OH, 44106, USA

    Corrilynn O. Hileman

  2. Department of Medicine, Division of Infectious Diseases, MetroHealth Medical Center, 2500 MetroHealth Drive, Cleveland, OH, 44109, USA

    Corrilynn O. Hileman

  3. 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

    Nicholas T. Funderburg

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Correspondence to Corrilynn O. Hileman.

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Corrilynn O. Hileman has received grant support from the National Institutes of Health (K23HL116209) and has served as consultant to Gilead Sciences.

Nicholas T. Funderburg has received grant support from the National Institutes of Health (R01HL134544).

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This article does not contain any studies with human or animal subjects performed by any of the authors.

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This article is part of the Topical Collection on HIV Pathogenesis and Treatment

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Hileman, C.O., Funderburg, N.T. Inflammation, Immune Activation, and Antiretroviral Therapy in HIV. Curr HIV/AIDS Rep 14, 93–100 (2017). https://doi.org/10.1007/s11904-017-0356-x

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