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Effect of antiretroviral therapy on inflammatory markers of endothelial dysfunction in HIV treatment‐Naïve infected patients

The aim of this study was to evaluate the effect of antiretroviral therapy on inflammatory markers of endothelial dysfunction in HIV treatment‐naïve infected patients. This was a prospective cohort study in HIV treatment‐naïve infected patients. The patients were assigned to a untreated group or a treatment group according to the therapeutic strategy received. Patients in the treatment group received efavirenz or lopinavir/ritonavir, each given with zidovudine and lamivudine. HIV RNA, CD4+ cell count, and the levels of hsCRP, sCD40L, sICAM‐1, sVCAM‐1, and sE‐selectin were measured before and 12 weeks after treatment. Fifty patients were enrolled: 13 in the untreated group and 37 in the treatment group; 48 (96%) completed the follow‐up. The mean (±SD) age was 33 ± 9 years, and 38 (79%) were men. The median pretreatment CD4+ cell counts were 263 cells/ml (IQR 118–341) in the treatment group and 658 cells/ml (IQR 475–887) in the untreated group. In the treatment group, the median serum sVCAM‐1 and sICAM‐1 levels decreased by a small but significant amount (1,400 and 228 ng/ml, respectively, P < 0.05) from before to after the 12 weeks. These levels did not change in the untreated group. Antiretroviral therapy is associated with a decrease in sVCAM‐1 and sICAM‐1 levels after 12 weeks of treatment. J. Med. Virol. 85:1321–1326, 2013. © 2013 Wiley Periodicals, Inc.