Sevelamer does not decrease lipopolysaccharide or soluble CD14 levels but decreases soluble tissue factor, low-density lipoprotein (LDL) cholesterol, and oxidized LDL cholesterol levels in individuals with untreated HIV infection

J Infect Dis. 2014 Nov 15;210(10):1549-54. doi: 10.1093/infdis/jiu305. Epub 2014 May 26.

Abstract

Abnormal levels of inflammation are associated with cardiovascular disease and mortality in human immunodeficiency virus (HIV)-infected patients. Microbial translocation, which may cause inflammation, is decreased by sevelamer in patients undergoing hemodialysis. In this single-arm study, we evaluated the effects of 8 weeks of sevelamer therapy on 36 HIV-infected subjects who were not receiving antiretroviral therapy. Sevelamer did not significantly change markers of microbial translocation, inflammation, or T-cell activation. During sevelamer treatment, however, levels of soluble tissue factor, low-density lipoprotein (LDL) cholesterol, and oxidized LDL cholesterol decreased significantly, whereas D-dimer levels increased. Thus, in this study population, sevelamer did not reduce microbial translocation but may have yielded cardiovascular benefits.

Clinical trials registration: NCT 01543958.

Trial registration: ClinicalTrials.gov NCT01543958.

Keywords: HIV; LDL; LPS; microbial translocation; oxLDL; sCD14; sevelamer; soluble tissue factor.

Publication types

  • Clinical Trial
  • Research Support, N.I.H., Extramural

MeSH terms

  • Adult
  • Bacterial Translocation*
  • Cardiovascular Agents / therapeutic use*
  • Cardiovascular Diseases / prevention & control
  • Cholesterol, LDL / blood*
  • HIV Infections / complications*
  • HIV Infections / drug therapy
  • Humans
  • Lipopolysaccharide Receptors / blood
  • Lipopolysaccharides / blood
  • Lipoproteins, LDL / blood*
  • Male
  • Middle Aged
  • Polyamines / therapeutic use*
  • Sevelamer
  • Thromboplastin / analysis*
  • Treatment Outcome
  • Young Adult

Substances

  • Cardiovascular Agents
  • Cholesterol, LDL
  • Lipopolysaccharide Receptors
  • Lipopolysaccharides
  • Lipoproteins, LDL
  • Polyamines
  • oxidized low density lipoprotein
  • Thromboplastin
  • Sevelamer

Associated data

  • ClinicalTrials.gov/NCT01543958

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