A pilot study linked to a long-running Nairobi partnership has found that aspirin may reduce the vaginal HIV target cells that help the virus establish infection in women.
The research focused on 37 Kenyan women and examined blood and vaginal samples before and after up to six weeks of aspirin use. According to the study, aspirin lowered the frequency of vaginal HIV target cells by about 35 per cent and made those cells less activated.
The work builds on more than 30 years of collaboration with women in Nairobi, Kenya, a relationship that helped establish a clinic serving almost 50,000 sex workers with prevention and treatment services. The World Health Organization and UNAIDS have often cited the clinic as a model of best practice.
Researchers said the finding matters because inflammation can draw immune cells to the site of infection and activate the very cells HIV prefers to infect. In women who naturally show resistance to HIV, low inflammation in the blood and genital tract appears to be part of that protection.
Alongside aspirin, the team also tested hydroxychloroquine, or HCQ. The drug, once widely used for malaria and now prescribed for autoimmune conditions such as rheumatoid arthritis, also appeared to reduce vaginal inflammation, though through a different mechanism.
The results were published in the Journal of the International AIDS Society. The researchers said aspirin may also strengthen the vaginal skin barrier, which could further limit HIV’s access to target cells in the blood.
The study comes against the backdrop of prevention tools such as PrEP, which is often delivered as a vaginal gel but has been shown not to work well for women with genital inflammation. The next step, the researchers said, is a clinical trial to test whether aspirin can reduce inflammation in women using PrEP and lower HIV infections among women at high risk, including female sex workers.
If that happens, aspirin would become the first drug to target the host rather than the virus in HIV prevention. The researchers also noted that such an approach would not be expected to drive HIV resistance, since the virus would not be under direct selective pressure.
They cautioned that aspirin is not yet recommended for HIV prevention, but said the possibility of a safe, affordable and widely available tool could add to efforts against a virus that has killed 35 million people worldwide.
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. Read the original article.
