A Randomized Controlled Trial of Lisinopril to Decrease Lymphoid Fibrosis in Antiretroviral-Treated, HIV-infected...

Area of Science:

• Immunology
• Virology
• Pharmacology

Background:

• HIV infection causes lymphoid tissue fibrosis.
• Angiotensin converting enzyme inhibitors possess anti-fibrotic properties.
• Pilot study investigating lisinopril's effect on gut fibrosis and HIV levels.

Purpose of the Study:

• To assess if lisinopril reverses gut tissue fibrosis in HIV-infected individuals on antiretroviral therapy (ART).
• To determine if lisinopril reduces HIV RNA and DNA levels in gut tissue.
• To evaluate secondary outcomes including blood HIV levels, T-cell responses, T-cell activation, and collagen deposition.

Main Methods:

• Thirty HIV-infected individuals on ART were randomized to lisinopril (20mg daily) or placebo for 24 weeks.
• Rectal biopsies and blood draws were performed before and after the 24-week treatment period.
• Primary endpoint: change in HIV RNA and DNA levels in rectal tissue.

Main Results:

• Lisinopril did not significantly affect HIV RNA or DNA levels in gut tissue or blood.
• No significant impact on Gag-specific T-cell responses or T-cell activation was observed.
• Lisinopril did not significantly alter lymphoid fibrosis in the rectum.

Conclusions:

• 24-week lisinopril treatment did not impact lymphoid fibrosis, immune activation, or gut viral reservoirs in HIV-infected adults.
• Further investigation is required to identify effective anti-fibrotic agents for HIV.
• Exploring alternative anti-fibrotic strategies may be beneficial for reversing lymphoid fibrosis and reducing HIV levels.