Multitasking Meds Combat HIV, Along With Alzheimer's and Diabetes

A flurry of stories broke this fall about the versatility of HIV medications and how they battle other diseases and conditions, in addition to news that a medication currently utilized for multiple sclerosis could fight HIV.

Researchers at Penn State University College of Medicine reported findings in October that indicated antiretroviral therapy for HIV reduces the risk of Alzheimer’s disease and early-onset Alzheimer’s. People living with HIV have a heightened chance of the degenerative disease, which impairs memory, speech, and most cognitive functions. The risk is even more pronounced, researchers found, for early-onset Alzheimer’s among people living with HIV. But for HIV-positive people who maintain their treatment regimen, the risk of Alzheimer’s is comparable to that of the general population.

Using public information on nearly 75,000 people aged 64 or younger and living with HIV, researchers looked at those not on HIV treatment and found the prevalence of Alzheimer’s higher among this group (0.11 percent) than those without HIV (0.07 percent). Early-onset Alzheimer’s was even more pervasive among those not on HIV meds (0.16 percent) than those without HIV. The occurrence of Alzheimer’s among HIV-positive people on treatment, though, was the same as for HIV-negative people (0.07 percent).

While no specific HIV medication was cited by researchers, the results appear to indicate that antiretrovirals battle more than just HIV. Scientists will now try to figure out how these antiretroviral drugs fight Alzheimer’s — they currently theorize it may be because the medications hinder “neurological toxicity” caused by unsuppressed HIV or because these meds also reduce the incidence of medical conditions seen as risk factors for Alzheimer’s, like hypertension, diabetes, and high cholesterol.

The Penn State findings are important for many reasons, including the fact that “the survivors of the early waves [of the HIV epidemic] are entering seniorhood,” Guodong Liu, Ph.D., associate professor of public health sciences and neurology, pediatrics, psychiatry, and behavioral health at the Penn State University College of Medicine, told Healio.

Just days before the Penn State announcement, researchers with the University of Virginia School of Medicine reported that medications used to treat HIV and hepatitis B slash the risk of developing diabetes by a third for these patients.

The drugs could be “repurposed” to prevent type 2 diabetes, a condition the Mayo Clinic describes as the body resisting the effects of insulin — a hormone that regulates the movement of sugar into your cells — or not producing enough insulin to maintain normal glucose levels.

Information for the findings was culled from records of over 128,000 people with HIV or hepatitis B, some of whom are veterans who receive their care from the Veterans Health Administration.

“The fact that the protective effect against the development of diabetes was replicated in multiple databases in studies from multiple institutions enhances confidence in the results,” researcher Jayakrishna Ambati, MD, of the University of Virginia School of Medicine, said in a statement.

The researchers also studied the effects of one specific drug, lamivudine, sold under the brand name Epivir and a component of Dovato, in human cells and in animals, and found evidence that it could reduce the risk of diabetes among people living with HIV.

Most recently, researchers at George Washington University and the University of Montreal found that the multiple sclerosis drug fingolimod, sold as Gilenya, can “hinder several key steps of the HIV lifecycle,” AIDSMap reported in November. Taken orally, fingolimod is now used to treat MS, a chronic autoimmune disease of the central nervous system that disrupts communication between the brain and the body. During their studies, the researchers found that fingolimod prevented cell-to-cell transmission of HIV.

“Fingolimod may be useful as a strategy to limit the size of the latent [HIV] reservoir if used prior to [antiretroviral] initiation, such as in acute infection,” researcher Rachel Resop, Ph.D., and her colleagues noted.