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Aspirin fails to improve immune activation in patients receiving ART
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Aspirin treatment for 12 weeks did not significantly impact HIV–related immune activation or endothelial dysfunction in patients with HIV who were receiving ART, study data show.
“Increased platelet reactivity is associated with an increased risk of cardiovascular events, thus, anti-platelet therapy is recommended in those at high risk for or with known CVD,” Meagan P. O’Brien, MD, of the department of medicine at Icahn School of Medicine, Mount Sinai, New York, and colleagues wrote. “Since platelets are activated in HIV infection and may contribute to immune activation, we hypothesized that blocking platelet activation with aspirin, an anti-platelet drug that irreversibly inhibits the COX-1 pathway, might decrease immune activation, coagulation and improve surrogate markers of CVD.”
O’Brien and colleagues carried out a prospective, double-blind trial on 121 patients with HIV who had been receiving ART for more than 48 weeks. Patients were randomized to three arms: 12 weeks of 100 mg of aspirin a day, 300 mg of aspirin a day and placebo. Researchers then evaluated the effects of aspirin on cellular immune activation markers, flow mediated dilation of the brachial artery and platelet COX-1 inhibition.
The two aspirin arms produced no change in soluble CD14, IL-6 or soluble CD163 the researchers reported. Similarly, aspirin did not change D-dimer, T-cell or monocyte activation or any of the other immunologic endpoints that were included in the study; nor did it change endothelial function. There was no significant difference between the performance of the aspirin and placebo arms.
O’Brien and colleagues pointed out that the results were different from those of a previous study, which indicated that daily aspirin could reduce sCD14 in patients receiving ART. The researchers wrote that the “reasons for the disparate results are unclear.”
“Until further data are available, the use of aspirin for the primary and secondary prevention of cardiovascular events in HIV infected patients should be individualized and prescribed according to the current guidelines for the general population,” the researchers wrote. – by Andy Polhamus
Disclosure: O’Brien reports no relevant financial disclosures. Please see the full study for a complete list of all other researchers’ relevant financial disclosures.
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