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Short Communication: A Pilot Study of the Effects of Losartan Versus Placebo on Pneumoproteins in HIV: A Secondary Analysis of a Randomized Double Blind Study

  • David M. MacDonald 1
  • Gary Collins 2
  • Chris H. Wendt 3
  • Julian Wolfson 2
  • Russell P. Tracy 4
  • Frank Rhame 5
  • Steven Deeks 6
  • Stacey A. Rizza 7
  • Zelalem Temesgen 7
  • Caryn Morse 8
  • Angelike P. Liappis 9
  • Irini Sereti 10
  • Jason V. Baker 11
  • Ken M. Kunisaki 12
  • 1 - Division of Pulmonary - Allergy - Critical Care - and Sleep Medicine - University of Minnesota - Minneapolis - Minnesota USA
  • 2 - Division of Biostatistics - University of Minnesota - Minneapolis - Minnesota USA
  • 3 - Division of Pulmonary - Allergy - Critical Care - and Sleep Medicine - University of Minnesota - Minneapolis - Minnesota USA
  • 4 - Department of Pathology and Laboratory Medicine - University of Vermont - Burlington - Vermont USA
  • 5 - Division of Infectious Diseases - Hennepin County Medical Center - Minneapolis - Minnesota USA
  • 6 - Department of Medicine - University of California - San Francisco - San Francisco - California USA
  • 7 - Division of Infectious Diseases - Mayo Clinic - Rochester - Minnesota USA
  • 8 - Laboratory of Immunoregulation - National Institute of Allergy and Infectious Diseases - National Institutes of Health - Bethesda - Maryland USA
  • 9 - Washington DC Veterans Affairs Medical Center - Section of Infectious Diseases and The George Washington University - Washington - District of Columbia USA
  • 10 - HIV Pathogenesis Section - Laboratory of Immunoregulation - National Institute of Allergy and Infectious Diseases - National Institutes of Health - Bethesda - Maryland USA
  • 11 - Division of Infectious Diseases - Hennepin County Medical Center - Minneapolis - Minnesota USA
  • 12 - Division of Pulmonary - Allergy - Critical Care - and Sleep Medicine - University of Minnesota - Minneapolis - Minnesota - USA

Abstract

HIV is an independent risk factor for lung disease, including chronic obstructive pulmonary disease (COPD) and emphysema. Angiotensin receptor blockers may be beneficial in COPD and emphysema through pathways that have been implicated in HIV-related lung disease. We performed a randomized comparison of the effects of losartan versus placebo on the plasma concentrations of the pneumoproteins, surfactant protein D (SPD) and club cell secretory protein (CCSP), in people living with HIV (PLWH). A total of 108 PLWH were included (52 assigned to losartan and 56 assigned to placebo). We found no difference in the change from baseline in log2 concentrations of CCSP or SPD over 1 year of follow-up. For SPD, we found a strong interaction by CD4+ counts, where those with CD4+ counts >350 cells/mm3 treated with losartan had more reduction (improvement) in SPD concentration than those treated with placebo (p value for interaction <.001). In conclusion, we did not find a beneficial effect of losartan on pneumoprotein concentrations in PLWH, but PLWH with higher CD4+ counts may have improvement in SPD when treated with losartan.

 


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