title: Aspirin attenuates platelet activation and immune activation in HIV-1-infected subjects on antiretroviral therapy: a pilot study.
abstract: BACKGROUND
  Mechanisms for increased cardiovascular risk in HIV-1-infected adults are incompletely understood, but platelet activation and immune activation leading to a prothrombotic state have been proposed as significant contributors. Aspirin has antiplatelet and immunomodulatory properties. We explored whether 1 week of low-dose aspirin attenuates platelet activation and immune activation in HIV-1-infected and virologically suppressed adults on antiretroviral therapy.
  
  
  METHODS
  Platelet activation and immune activation were measured in HIV-1-infected subjects virologically suppressed on antiretroviral therapy and controls before and after 1 week of low-dose aspirin.
  
  
  RESULTS
  Compared with control subjects, HIV-1-infected subjects had increased platelet activation, as measured by spontaneous platelet aggregation and aggregation in response to adenosine diphosphate, collagen, and arachidonic acid. After aspirin therapy, percent aggregation decreased similarly in both HIV-1-infected and control subjects to all platelet agonists tested except aggregation in response to arachidonic acid, which remained elevated in the HIV-1-infected group. HIV-1-infected subjects exhibited increased markers of T-cell activation (CD38 and HLA-DR) and monocyte activation (sCD14), which decreased after 1 week of aspirin therapy. Moreover, leukocyte responses to Toll-like receptor stimulation were enhanced after 1 week of aspirin therapy. In vitro studies showed that HIV-1 plasma could activate healthy platelets, which in turn activated monocytes, implicating a direct role for activated platelets in immune activation.
  
  
  CONCLUSIONS
  Our data demonstrate that heightened platelet activation and immune activation in treated HIV-1 disease are attenuated by 1 week of aspirin therapy. Aspirin should be further studied for its antithrombotic and immunomodulatory benefits in treated HIV-1 disease.
authors: Division of Infectious Diseases and Immunology, Cancer Institute, New York University, School of Medicine, New York, NY, USA. meagan.o'brien@nyumc.org
authors: Meagan
authors: M
authors: O'Brien
authors: Emilie
authors: E
authors: Montenont
authors: Liang
authors: L
authors: Hu
authors: Michael A
authors: MA
authors: Nardi
authors: Vanessa
authors: V
authors: Valdes
authors: Michael
authors: M
authors: Merolla
authors: Gabrielle
authors: G
authors: Gettenberg
authors: Karen
authors: K
authors: Cavanagh
authors: Judith A
authors: JA
authors: Aberg
authors: Nina
authors: N
authors: Bhardwaj
authors: Jeffrey S
authors: JS
authors: Berger
mesh_terms: D000244:Adenosine Diphosphate / Q000494:pharmacology; D000328:Adult; D000368:Aged; D019380:Anti-HIV Agents / Q000627:therapeutic use; D016718:Arachidonic Acid / Q000494:pharmacology; D001241:Aspirin / Q000494:pharmacology / Q000627:therapeutic use*; D002478:Cells, Cultured; D003094:Collagen / Q000494:pharmacology; D005260:Female; D015658:HIV Infections / Q000097:blood* / Q000188:drug therapy / Q000276:immunology*; D015497:HIV-1 / Q000187:drug effects; D006801:Humans; D007249:Inflammation / Q000188:drug therapy; D008213:Lymphocyte Activation / Q000187:drug effects*; D008297:Male; D008875:Middle Aged; D019007:P-Selectin / Q000097:blood; D010865:Pilot Projects; D015539:Platelet Activation / Q000187:drug effects*; D010974:Platelet Aggregation / Q000187:drug effects; D010975:Platelet Aggregation Inhibitors / Q000494:pharmacology / Q000627:therapeutic use; D010979:Platelet Function Tests; D013931:Thromboxanes / Q000652:urine; D055815:Young Adult
chemical_list: D019380:Anti-HIV Agents; D019007:P-Selectin; D010975:Platelet Aggregation Inhibitors; D013931:Thromboxanes; D016718:Arachidonic Acid; D000244:Adenosine Diphosphate; D003094:Collagen; D001241:Aspirin