A pilot study has raised the possibility that aspirin could help reduce HIV risk in women by lowering the number of cells the virus targets. The research focused on 37 Kenyan women and found measurable changes after up to six weeks of treatment.
The study’s authors say the drug reduced the frequency of vaginal HIV target cells by about 35 per cent and also made those cells less activated. They reported the findings in the Journal of the International AIDS Society.
The work grew out of a long-running partnership with women in Nairobi, Kenya, spanning more than 30 years. That relationship helped establish a clinic that provides prevention and treatment services to almost 50,000 sex workers, and the site is often cited by the WHO and UNAIDS as a model of best practice.
Researchers said many of the women in that community appear naturally resistant to HIV in part because they have very low inflammation in the blood and genital tract. Their argument is that inflammation can draw immune cells to the area and activate the very cells HIV infects most easily.
Instead of attacking the virus directly, the study asked whether aspirin, as an anti-inflammatory drug, could make the body less susceptible to infection. The team also tested hydroxychloroquine (HCQ), a drug once widely used for malaria and now used in autoimmune conditions such as rheumatoid arthritis.
HCQ also appeared to reduce inflammation in the vagina, though in a different way from aspirin. The researchers said aspirin additionally seemed to improve the structural integrity of vaginal skin, which could further limit HIV’s access to target cells in the blood.
The findings matter because PrEP, including daily anti-HIV drugs used for prevention and sometimes delivered as a vaginal gel, does not work well for women with genital inflammation. The authors say the next step is a clinical trial to see whether aspirin can reduce inflammation in women using PrEP and lower HIV infections among women at high risk, including female sex workers.
They say aspirin would be the first drug to target the host rather than the virus if that approach is proven effective. They also note that such a strategy would not be expected to drive HIV resistance in the way virus-targeting drugs can.
The researchers stopped short of recommending aspirin for HIV prevention. Even so, they said a safe, affordable, accessible and non-stigmatizing option would be a major addition to HIV prevention efforts, especially against a virus that has killed 35 million people.
By Colin Graydon, PhD Candidate in Medical Microbiology, University of Manitoba, and Monika Kowatsch, PhD Student in Medical Microbiology, University of Manitoba. This article is republished from The Conversation under a Creative Commons license.
