A class of HIV drugs might protect against Alzheimer’s

[Jim Allen]

Aidsmap article in full: https://www.aidsmap.com/news/may-2024/class-hiv-drugs-might-protect-against-alzheimers

In Brief:

A cohort of people with HIV who took NRTIs (a class of HIV drugs) as part of HIV treatment showed lower rates of Alzheimer’s disease than people without HIV.

Nucleoside reverse transcriptase inhibitors (NRTIs) are a class of drugs that block HIV’s RT enzyme. Since HIV’s RT is similar to the RTs produced in our cells, these same drugs may have the potential to block them too, possibly protecting against Alzheimer’s disease.

The researchers collected data on three cohorts of people – those with HIV taking NRTIs; those with HIV either on an NRTI-free regimen or off treatment; and a third cohort who were not living with HIV nor taking NRTIs. They followed up each cohort for two years and nine months to see whether NRTIs reduced the rate of Alzheimer’s.

The data came from a large number of people, which reduces the likelihood of these findings being a chance event. Over 46,000 people were included in the cohort of those with HIV on NRTI-containing regimens. There were 33,000 people in the cohort of people with HIV not taking NRTIs and 151,000 people in the cohort without HIV and not taking NRTIs.

During the two years and nine months of follow-up, the rate of developing Alzheimer’s was lowest in the first cohort – people with HIV on an NRTI-containing regimen. In this cohort only 2.46 in 1000 people developed Alzheimer's disease.

In the second cohort of those with HIV either on an NRTI-free regimen or off treatment the rate of Alzheimer’s was higher compared to the first cohort, but still lower than the third cohort of those without HIV. However, the difference between this cohort and those without HIV became insignificant when age and sex were added to the analysis. In this cohort the rate of Alzheimer’s was 3.55 in 1000 people.

The third cohort had the highest rate of Alzheimer’s at 6.15 in 1000 people.

Interestingly, a further analysis of the first cohort revealed an increased rate of Alzheimer’s in those taking protease inhibitors (another class of HIV drugs) alongside their NRTIs. However, the difference was not statistically significant and it would be early to make any conclusions.

Last but not least, this was a retrospective study (one that collects data on the past medical records of people). Besides, it has a set of limitations such as a relatively short follow-up period and non-ideal match between cohorts with regards to age and sex. Randomised controlled studies would be required to get a more definitive answer to whether NRTIs protect against Alzheimer’s disease in people without HIV.

[Jim Allen]

Previous related topics.
 
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HIV Medication Epivir Could Possibly Treat Alzheimer’s
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