Επίδραση της αντιρετροϊκής αγωγής στο μεταβολισμό του παράγοντα ενεργοποίησης των αιμοπεταλίων

Abstract

The progress of antiretroviral therapy has converted HIV infection from a deathsentence into a chronic disease. Eventhought, numerous factors, related either tothe virus itself or the antiretroviral therapy, are responsible for the lower lifeexpectancy and the higher inflammatory markers of HIV patients compared to theaverage population. This condition has been defined as immune activation and isresponsible for many pathological conditions namely “non-AIDS morbidities” such asmalignancies, cardiovascular and renal disease. The inflammatory background ofthe above pathological conditions has raised questions about the in vivo effect of theantiretroviral therapy on the metabolism of Platelet Activating Factor (PAF), the mostpotent inflammatory mediator. In order to elucidate this effect, 50 male,asymptomatic and naïve HIV-infected patients have been recruited and divided into5 groups according to their antiretroviral therapy; Group A received tenofovirDF/emtricitabine/efavirenz, Group B received abacavir/lamivudine/ efavirenz, GroupC received tenofovir-DF/emtricitabine/ atazanavir-r, Group D receivedabacavir/lamivudine/ atazanavir-r and Group N was the positive control groupconsisted of the naïve patients. After 6 blood donations within 12 months, PAF levelsand the specific activity of PAF metabolic enzymes were defined in patients‟ blood.The results display the effect of antiretroviral therapy on PAF metabolism, havingeither an inhibitory or an activating action. In addition, PAF seems to be implicated inthe immune activation as well in the non-AIDS morbidities. The present data couldtrigger the research and development of antiretrovirals with anti-inflammatory andespecially anti-PAF actions in order to diminish chronic activation and its harmfulconsequences during HIV infection.