Enzyme May Protect Against Cardiovascular Disease in Patients with HIV

Protease inhibitors can frequently lead to cardiovascular disease, diabetes, and obesity.

An enzyme showed the potential to reduce the risk of developing cardiovascular disease in patients with HIV who are taking antiviral medications during a recent study.

Although antiviral medications are commonly used to help manage HIV and prevent the disease from progressing to AIDS, these medications have been linked to the development of cardiovascular disease, diabetes, and obesity.

“The use of antivirals in HIV patients is very important to control the virus, suppress symptoms and improve quality of life," said lead study author William Durante, PhD. “Our study focused on protease inhibitors, a very common antiviral used to treat HIV.”

Protease inhibitors are responsible for disrupting HIV from replicating and infecting cells. However, they also cause endothelial cell malfunction, which could lead to the development of cardiovascular disease.

“Endothelial cells make up the inner lining of blood vessels and are essential to vascular health,” Durante said. “When protease inhibitors are used to treat HIV, endothelial cell function is compromised. The cells' natural tendency to promote blood flow through the vessel is lost and they also become inflamed. These issues lead to plaque build-up within arteries and, ultimately, cardiovascular disease.”

Prior studies found that the enzyme heme oxygenase-1 (HO-1) protects against endothelial dysfunction. Therefore, during the current study, published in Free Radical Biology and Medicine, researchers used a cell-based model of cultured human endothelial cells and increased the number of enzymes within the cells.

“Increasing the presence of HO-1 in our model before exposing it to a protease inhibitor allowed the medication to do its job without causing endothelial dysfunction,” Durante said. “HO-1 shows great promise as a defender of endothelial cells in patients being treated for HIV.”

Although the study had promising results, more research is needed to confirm that HO-1 can prevent endothelial cell dysfunction with all antiviral medications.