Researchers Identify New Cause of HIV-Related Chronic Inflammation

The inability to control human immunodeficiency virus (HIV) RNA production may be a major factor driving inflammation in people living with HIV, according to a new study published in the Journal of Infectious Diseases.

An estimated 1.2 million people living with HIV in the United States. HIV-positive individuals face chronic inflammation, which leads to earlier onset of age-associated diseases, such as atherosclerosis, cancer, or neurocognitive decline.

The investigators examined plasma markers, cell-associated virus levels, and ability to stimulate RNA transcription in latently infected cell lines among 57 individuals with HIV who were treated with antiretroviral therapy (ART). They compared inflammation among younger (<35 years) and older (>50 years) participants, as well as the ability of the inflammation to activate HIV production.

Results showed that cell-associated RNA, but not intact provirus level, had positive correlation with plasma D-Dimer levels, which are associated with inflammation. Older patients had higher levels of D-dimer and cell-associated RNA, but similar levels of intact proviruses. Though inflammatory markers were relatively higher in older individuals, this greater inflammation did not induce more HIV transcription in infected cell lines. These results suggest that uncontrolled RNA production even with ART correlates with inflammation.

“Our findings suggest that novel treatments are needed to target the inflammation persistent in people living with HIV,” said co-author Manish Sagar, MD, in a press release. “Current antiretroviral drugs prevent new infection, but they do not prevent HIV RNA production, which our results point as a potential key factor driving inflammation in people living with HIV.”