Diabetes Drug Reduces Heart Attack Risk in HIV Patients

Drug mitigates elevated cardiovascular risk in infected patients.

A drug commonly used to lower blood sugar may also prevent heart attacks in patients infected with HIV.

Partially due to chronic inflammation, HIV-infected adults face an elevated risk of heart attacks, diabetes, and issues with glucose, insulin, and cholesterol. A study published in The Journal of Clinical Endocrinology & Metabolism found the diabetes drug sitagliptin (Januvia) boosted metabolism and decreased inflammation in HIV-positive patients on antiretroviral therapy.

"The goal has been to identify treatments that not only address problems with blood sugar and lipids but also can lower inflammation, which can play a substantial role in heart disease and stroke," said principal investigator Kevin E. Yarasheski, PhD, in a press release. "With sitagliptin, sugar levels fell, and several markers of immune activation and inflammation were reduced, indicating the drug may provide long-term benefits for these patients' hearts, bones and livers."

The study noted that standard diabetes treatments in HIV patients have achieved some success in the past without completely normalizing blood sugar, insulin and lipid levels, in addition to other indicators of heart and metabolic health.

For the current 8-week study of sitagliptin, researchers evaluated whether the drug offers specific health benefits.

The study included 36 HIV patients age 18 to 65 years who were on antiretroviral therapy with a stable immune status. At baseline, the researchers measured glucose levels, insulin sensitivity, lipid levels, immune cell counts, and various markers of inflammation and indicators of health.

While the preliminary results are promising, additional long-term studies are needed to evaluate if lower inflammation markers after 8 weeks of treatment can lower the risk for heart attacks and metabolic problems.

"Lowering blood sugar isn't enough," Yarasheski said. "Just treating lipids isn't enough. We want to target the nexus between metabolic regulation and immune regulation. Whether this particular drug lowers inflammation enough to actually reduce cardiovascular disease, heart attack, stroke and hypertension is a question that still needs to be addressed. But these findings are a step in the right direction."