This session of the CROI meeting was entitled Progression of Arteriosclerosis: role of inflammation and T Cell Activation

This session of the CROI meeting was entitled Progression of Arteriosclerosis: role of inflammation and T Cell Activation

It is now becoming clear that the progression of Cardiovascular disease is associated with HIV infection. In fact arteriosclerosis, heart disease, and stroke may contribute more to mortality and death than immune suppression leading to AIDS. A person who is HIV+ who is treated earlier and maintains viral suppression for 2 years can have the same life expectancy as an HIV- person of the same age. Now it is time to work on some of the co-morbidities associated with HIV infection such as Heart disease.

The first paper demonstrated that earlier initiation of antireroviral therapy is associated with decreased vessel stiffness. Viral stiffness and subsequent clots and endothelial swelling of the arteries are associated with cardiovascular events. So the point of the study is to start treatment of HIV infection earlier to stop the process that is causing increased cardiovascular disease.

The second paper talked about the inflammation that is present in the arteries which causes endothelial swelling and subsequent cardiovascular problems. Again the object is to stop the inflammation, Antiretroviral therapy starting early can decrease the inflammation, caused by untreated HIV infection.

The third paper talked about T-cell activation and T-cell senescence in HIV infection. It is becoming apparent time and time in these sessions that the major marker to follow in HIV disease is not viral load or CD 4 count but activation of T cells. This can be measured by the markers of T cells, like CD 38 for activation and CD 28 for senescence. These are the markers that people should pay as much attention to as viral load and CD 4 count.

It is interesting that in vascular disease and cardiovascular events, blue green algae may prove to be of great benefit. Blue green algae has among its natural components L-selectin ligand, and phycocyanin. L-selectin Ligand releases adult bone marrow stem cells into the circulation, and stem cells are directed to the place of injury, in the above situation the vascular tree. In addition phycocynain, a chlorophyll agent is very anti inflammatory, and at the place of injury that HIV causes, like in the vascular tree, it cuts done on inflammation.

Blue green algae may find its greatest use in Cardiovascular disease caused by HIV, in decreasing the immune activation, the inflammation that is so prominent in all the manifestations of HIV disease, particularly cardiovascular disease, which is becoming the #1 killer of HIV+ patients.