Promising Strategy to Reduce Heart Disease Risk in People with HIV

Although antiviral medications help control the human immunodeficiency virus (HIV), treatment can increase the risk of cardiovascular disease. A new study identifies a strategy to reduce that risk.

Antivirals helps extend patients’ lives by preventing HIV from progressing to AIDS. However, the treatment can cause other health conditions, such as diabetes, obesity, and heart disease. Researchers at the University of Missouri (MU) School of Medicine pinpointed an enzyme that can help reduce that heart disease risk.

Protease inhibitors are a common form of antiviral therapy and work by stopping the virus from replicating and infecting cells. On the down side, the protease inhibitors also cause malfunction in the endothelial cells, which are essential to vascular health. Therefore, problems with these cells found in the lining of blood vessels can lead to cardiovascular disease.

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“When protease inhibitors are used to treat HIV, endothelial cell function is compromised. The cells’ natural tendency to promote blood flow through the vessel is lost and they also become inflamed. These issues lead to plaque build-up within arteries and, ultimately, cardiovascular disease,” lead author William Durante, PhD, explained in a news release.

Previous research has shown that the enzyme heme oxygenase-1 (HO-1) can protect against endothelial cell malfunction. The MU School of Medicine team used a model of human endothelial cells to uncover how to increase the amount of HO-1 enzymes in the cells, as described in Free Radical Biology and Medicine. They introduced three protease inhibitors — ritonavir, atazanavir, and lopinavir – to assess disease activity.

“Increasing the presence of HO-1 in our model before exposing it to a protease inhibitor allowed the medication to do its job without causing endothelial dysfunction,” confirmed Durante, a professor of medical pharmacology and physiology at the MU School of Medicine.

Although more studies are needed to verify the findings, it appears that this enzyme can protect endothelial cells for patients with HIV being treated with antivirals.

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