2010 September/October 

Inflammation and HIV

At the beginning of the AIDS epidemic, complications and deaths from life-threatening infections were common. Now that potent anti-HIV therapy (commonly called ART or HAART) is widely available in most high-income countries, deaths from AIDS-related infections are no longer common.

ART has this amazing effect because it greatly reduces production of HIV. This allows the immune system to partially repair itself. However, while these repairs give the immune system the ability to resist common AIDS-related infections, other issues remain unresolved.

Because ART cannot cure HIV infection, HIV continues to be produced and this affects the immune system, keeping it in a state of continuous activation. Cells of the immune system can take up residence within other organ-systems—bones, brain, blood vessels, liver, lungs, kidneys and so on. There, activated immune cells release inflammatory chemical signals. Over the long-term, continuous production of these chemical signals can degrade and weaken these organ-systems.

Increased inflammation likely plays a role in some of the emerging complications that are being seen in HIV-positive people today in high-income countries, including:

  • cardiovascular disease (heart attack and stroke)
  • pulmonary hypertension and lung cancer
  • dysfunctional liver and kidneys
  • diabetes
  • thinning bones
  • problems with memory and thinking clearly

Ways of reducing inflammation and assessing its effect on the health of HIV-positive people are being explored in clinical trials. For further information about HIV-related inflammation and some of these experiments, see CATIE News: