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Cocaine use modifies the association between antiretroviral therapy and endothelial dysfunction among adults with HIV

Ji Li1, Hong Lai2, Shaoguang Chen1

  • 1Department of Pathology, Johns Hopkins School of Medicine, Baltimore, Maryland.

Journal of Medical Virology
|May 31, 2019
PubMed

Insights

Cocaine use alters how antiretroviral therapy (ART) affects endothelial dysfunction in HIV patients. Reducing cocaine use may improve vascular health in HIV-infected individuals using ART.

Area of Science:

  • Cardiovascular Science
  • Infectious Disease Research
  • Pharmacology

Background:

  • Cocaine use is prevalent among people with HIV and may accelerate disease progression.
  • Antiretroviral therapy (ART) regimens are implicated in endothelial dysfunction.
  • The interaction between cocaine use and ART's impact on endothelial function in HIV is not fully understood.

Purpose of the Study:

  • To investigate if cocaine use modifies the association between antiretroviral therapy (ART) regimens and endothelial dysfunction in adults with HIV.
  • To analyze the impact of specific ART classes on endothelial dysfunction biomarkers in the context of cocaine use.

Main Methods:

  • A cohort of 466 HIV-positive participants in Baltimore, MD, was studied between 2003 and 2014.
  • Robust regression models analyzed risk factors and endothelial dysfunction indicators in overall and cocaine-using subgroups.
  • Specific biomarkers like plasma vWF:Ag and endothelin-1 (ET-1) were assessed.

Main Results:

  • Longer duration of nonnucleoside reverse-transcriptase inhibitor (NNRTI)-based therapy correlated with lower plasma vWF:Ag in cocaine non-users.
  • Cocaine users on extended NNRTI therapy showed higher plasma endothelin-1 (ET-1) levels.
  • Current cigarette smoking was positively associated with ET-1 in both cocaine users and non-users.

Conclusions:

  • Cocaine use significantly modifies the effects of NNRTI-based ART on biomarkers of endothelial dysfunction.
  • Findings suggest that reducing cocaine use could potentially improve endothelial function in HIV-infected individuals.
  • This highlights the importance of addressing substance use in managing cardiovascular comorbidities in HIV.

Keywords:
HIV infectionantiretroviral therapycocaine useendothelin-1von Willebrand factor antigen

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