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Sevelamer does not decrease lipopolysaccharide or soluble CD14 levels but decreases soluble tissue factor,

Netanya G Sandler, Xinyan Zhang, Ronald J Bosch

    The Journal of Infectious Diseases
    |May 28, 2014
    PubMed

    Insights

    Sevelamer did not reduce microbial translocation or inflammation in HIV patients. However, it lowered LDL cholesterol and soluble tissue factor, suggesting potential cardiovascular benefits.

    Area of Science:

    • Cardiovascular Disease Research
    • HIV/AIDS Research
    • Inflammation Studies

    Background:

    • Abnormal inflammation is linked to cardiovascular disease and mortality in HIV patients.
    • Sevelamer, a phosphate binder, may reduce inflammation by decreasing microbial translocation.
    • Clinical trial NCT 01543958 investigated sevelamer's effects in HIV-infected individuals.

    Purpose of the Study:

    • To evaluate the impact of sevelamer therapy on microbial translocation, inflammation, and cardiovascular markers in HIV-infected patients not on antiretroviral therapy.

    Main Methods:

    • A single-arm study involving 36 HIV-infected subjects.
    • 8 weeks of sevelamer treatment.
    • Assessment of microbial translocation, inflammation, T-cell activation, soluble tissue factor, LDL cholesterol, oxidized LDL cholesterol, and D-dimer levels.

    Main Results:

    • Sevelamer did not significantly alter markers of microbial translocation, inflammation, or T-cell activation.
    • Significant decreases were observed in soluble tissue factor, LDL cholesterol, and oxidized LDL cholesterol levels.
    • D-dimer levels showed a significant increase during sevelamer treatment.

    Conclusions:

    • Sevelamer therapy did not reduce microbial translocation in this HIV-infected population.
    • The observed reductions in LDL cholesterol and soluble tissue factor suggest potential cardiovascular benefits.
    • Further research is warranted to explore sevelamer's role in managing cardiovascular risk in HIV patients.
    Abstract

    Keywords:
    HIVLDLLPSmicrobial translocationoxLDLsCD14sevelamersoluble tissue factor

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