Certain HIV Drugs May Prevent Common Cause of Vision Loss

The class of HIV drugs known as nucleoside reverse transcriptase inhibitors may help prevent dry macular degeneration, a leading cause of vision loss, according to a new study.

Researchers at the University of Virginia School of Medicine looked at four health insurance databases and found that people taking NRTIs were almost 40 percent less likely than others to develop dry macular degeneration, even though that condition isn’t caused by a virus. The databases encompassed more than 100 million people over two decades.

“We are extremely excited that the reduced risk was reproduced in all the databases, each with millions of patients,” Jayakrishna Ambati, MD, a macular degeneration researcher at the medical school, said in a university press release. “This finding provides real hope in developing the first treatment for this blinding disease.”

The class of NRTIs includes such common HIV drugs as Viread, Retrovir, Videx, Ziagen, and many others. They work against HIV by blocking reverse transcriptase, one of the enzymes the virus uses to reproduce its DNA. The researchers decided to analyze the effects of drugs that block DNA production after they realized that the buildup of a certain type of DNA known as Alu can contribute to dry macular degeneration — the thinning of the macula, the portion of the retina responsible for clear vision in a person’s direct line of sight — by destroying a layer of cells that nourishes the retina.

The UVA researchers are calling for a clinical trial to determine the effectiveness of NRTIs or a related type of drugs dubbed Kamuvudines in preventing vision loss. Such a trial “is now warranted,” Ambati said. “It’s also fascinating how uncovering the intricate biology of genetics and combining it with big data archeology can propel insights into new medicines.”

Ambati had previously determined that NRTIs may help prevent diabetes as well. He and his team published their macular degeneration study in the journal PNAS.