Abacavir alters the transcription of inflammatory cytokines in virologically suppressed, HIV-infected women

Background: Abacavir (ABC) may be associated with a small, increased risk of myocardial infarction in HIV-infected adults, possibly related to cytokine-mediated inflammation. Methods: To evaluate the induction of inflammatory cytokine transcription by ABC, we used samples from women randomized to receive zidovudine/lamivudine/ABC (Trizivir) or lopinavir/ritonavir and zidovudine/lamividine (Kaletra/Combivir) ffrom the third trimester through six-months postpartum for the prevention of mother-to-child transmission (PMTCT). Women were matched by CD4 count and baseline HIV RNA. All women attained viral suppression ( Results: Four cytokines showed a difference in expression between the treatment arms, all in a proinflammatory direction for the ABC arm: CD40LG 1.82-fold, (p = .027); IL-8 3.16-fold (p = .020); LTA 2.82-fold, (p = .008); and CCL5-1.67-fold, (p = .035). At 12-months postpartum, 6-months after antiretroviral discontinuation, cytokine expression was similar by treatment arm. Conclusions: We conclude that ABC may upregulate proinflammatory cytokines at the transcriptional level in this population. Keywords: HIV; abacavir; cytokine; transcription; antiretroviral; inflammation; AIDS.
Introduction Abacavir (ABC) may be associated with a small, increased risk of myocardial infarction (MI) in HIV-infected adults, possibly related to cytokine-mediated inflammation; however, no consistent outcome has been found [...]