Immunomodulatory and Anti-Inflammatory Strategies to Reduce Comorbidity Risk in People with HIV

Curr HIV/AIDS Rep. 2020 Aug;17(4):394-404. doi: 10.1007/s11904-020-00509-y.

Abstract

Purpose of review: In this review, we will discuss treatment interventions targeting drivers of immune activation and chronic inflammation in PWH.

Recent findings: Potential treatment strategies to prevent the progression of comorbidities in PWH have been identified. These studies include, among others, the use of statins to modulate lipid alterations and subsequent innate immune receptor activation, probiotics to restore healthy gut microbiota and reduce microbial translocation, hydroxychloroquine to reduce immune activation by altering Toll-like receptors function and expression, and canakinumab to block the action of a major pro-inflammatory cytokine IL-1β. Although many of the treatment strategies discussed here show promise, due to the complex nature of chronic inflammation and comorbidities in PWH, larger clinical studies are needed to understand and target the prominent drivers and inflammatory cascades underlying these end-organ diseases.

Keywords: Comorbidities; HIV; Immune activation; Inflammation.

Publication types

  • Research Support, N.I.H., Extramural
  • Review

MeSH terms

  • Anti-Inflammatory Agents / therapeutic use*
  • Anti-Retroviral Agents / therapeutic use
  • Antibodies, Monoclonal, Humanized / therapeutic use
  • Comorbidity
  • Gastrointestinal Microbiome / drug effects
  • HIV Infections / drug therapy
  • HIV Infections / pathology
  • Humans
  • Hydroxychloroquine / therapeutic use
  • Hydroxymethylglutaryl-CoA Reductase Inhibitors / therapeutic use*
  • Immunologic Factors / therapeutic use*
  • Inflammation / drug therapy
  • Inflammation / immunology
  • Inflammation / prevention & control*
  • Interleukin-1beta / antagonists & inhibitors
  • Lipids / blood
  • Probiotics / therapeutic use*

Substances

  • Anti-Inflammatory Agents
  • Anti-Retroviral Agents
  • Antibodies, Monoclonal, Humanized
  • Hydroxymethylglutaryl-CoA Reductase Inhibitors
  • IL1B protein, human
  • Immunologic Factors
  • Interleukin-1beta
  • Lipids
  • canakinumab
  • Hydroxychloroquine