Effects of abacavir: A Synthesis of Findings from 13 Studies

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Original Abstract of the Article

Major Research Findings

Abacavir is an antiretroviral drug used in HIV treatment. Abacavir has been shown to be an effective treatment for HIV, and may be a better option than tenofovir disoproxil fumarate (TDF) for maintaining bone density. 4 Studies have shown that abacavir may be less likely to cause kidney problems than TDF. 8 However, abacavir may have negative effects on the heart, and can interact with HIV protein Tat, potentially increasing heart risk. 7 It has also been shown that abacavir can cause an interaction between white blood cells and platelets, potentially increasing the risk of blood clots. 13 Abacavir may also increase inflammation, which can increase cardiovascular risk. 9 Additionally, abacavir may cause a severe allergic reaction in people who have the HLA-B*57:01 gene. 12 This reaction can cause symptoms such as skin rash, fever, swollen lymph nodes, and liver or kidney problems. 10 Abacavir use during pregnancy may also increase the risk of low birth weight and miscarriage. 11

Benefits and Risks

Benefits Summary

Abacavir may help to maintain bone density better than TDF. 4 It may also be less likely to cause kidney problems than TDF. 8

Risks Summary

Abacavir may have negative effects on the heart, and can interact with HIV protein Tat, potentially increasing heart risk. 7 It has also been shown that abacavir can cause an interaction between white blood cells and platelets, potentially increasing the risk of blood clots. 13 Abacavir may also increase inflammation, which can increase cardiovascular risk. 9 Additionally, abacavir may cause a severe allergic reaction in people who have the HLA-B*57:01 gene. 12 This reaction can cause symptoms such as skin rash, fever, swollen lymph nodes, and liver or kidney problems. 10 Abacavir use during pregnancy may also increase the risk of low birth weight and miscarriage. 11

Comparison of Studies

Commonalities

Multiple studies have shown that abacavir is an effective treatment for HIV. Abacavir may help maintain bone density better than TDF and may be less likely to cause kidney problems compared to TDF.

Differences

Abacavir may have negative effects on the heart, and can interact with HIV protein Tat, potentially increasing heart risk. Abacavir can cause an interaction between white blood cells and platelets, potentially increasing the risk of blood clots. Additionally, abacavir may cause a severe allergic reaction in people who have the HLA-B*57:01 gene. This reaction can cause symptoms such as skin rash, fever, swollen lymph nodes, and liver or kidney problems. Abacavir use during pregnancy may also increase the risk of low birth weight and miscarriage.

Consistency and Contradictions of Findings

Multiple studies have shown that abacavir is an effective treatment for HIV. However, abacavir may have negative effects on the heart, and can interact with HIV protein Tat, potentially increasing heart risk. Abacavir can cause an interaction between white blood cells and platelets, potentially increasing the risk of blood clots. Additionally, abacavir may cause a severe allergic reaction in people who have the HLA-B*57:01 gene. These risks suggest that abacavir use should be carefully considered.

Practical Application Notes

While abacavir has been proven to be effective in multiple studies, abacavir may have negative effects on the heart, and can interact with HIV protein Tat, potentially increasing heart risk. Abacavir can cause an interaction between white blood cells and platelets, potentially increasing the risk of blood clots. Additionally, abacavir may cause a severe allergic reaction in people who have the HLA-B*57:01 gene. These risks must be considered and abacavir should only be used under a doctor's supervision.

Limitations of Current Research

There is still much research to be done on abacavir, particularly in the long-term effects.

Future Directions

More research is needed on abacavir, particularly on its long-term effects, effects on the heart, the risk of blood clots, allergic reactions in those with the HLA-B*57:01 gene, and the effects of abacavir use during pregnancy.

Conclusion

Abacavir has been shown to be an effective treatment for HIV in multiple studies, but there are also potential risks associated with its use. These risks include heart problems, an increased risk of blood clots, and allergic reactions in those with the HLA-B*57:01 gene. Abacavir should be used with caution, under a doctor's supervision. Further research is needed on abacavir to fully understand its long-term effects, effects on the heart, and the risk of blood clots, as well as to fully understand the potential for allergic reactions in those with the HLA-B*57:01 gene and the effects of abacavir use during pregnancy.

Literature analysis of 13 papers
Positive Content
9
Neutral Content
0
Negative Content
4
Article Type
3
0
0
1
13
1.

Abacavir-based therapy does not affect biological mechanisms associated with cardiovascular dysfunction.

Author: MartínezEsteban, LarrousseMaría, PodzamczerDaniel, PérezIgnacio, GutiérrezFélix, LoncáMontserrat, BarragánPatricia, DeulofeuRamón, CasamitjanaRoser, MallolasJosep, PichJudit, GatellJosé M,

HIV-infected patient treatment
Increased LDL cholesterol
Increased total cholesterol

Abacavir/lamivudine increased total and LDL cholesterol compared with tenofovir/emtricitabine, but it did not cause inflammation, endothelial dysfunction, insulin resistance, or hypercoagulability in virologically suppressed HIV-infected patients.

Journal ArticleAn article published in an academic or professional journal that reports original research or scholarly analysis.
Randomized Controlled TrialA clinical trial that randomly assigns participants to treatment and control groups to evaluate the effects of an intervention.
Research Support, Non-U.S. Gov'tResearch funding provided by government agencies outside the United States.

Language : English

2.

Dyslipidemia and associated risk factors among HIV/AIDS patients on HAART in Asmara, Eritrea.

Author: AchilaOliver Okoth, AbrhaleyFeven, KeseteYafet, TesfaldetFeven, AlazarFilmon, FisshayeLidya, GebremeskelLidya, MehariRodas, AndemichaelDanait

HIV/AIDS treatment
Lipid toxicities

This study aimed to determine the frequency and risks of dyslipidemia in HIV patients on HAART medication in Eritrea. The study found that dyslipidemia was prevalent among HIV patients on HAART medication, highlighting the need for routine lipid monitoring and management.

Journal ArticleAn article published in an academic or professional journal that reports original research or scholarly analysis.

Language : English

4.

Bone mineral density, kidney function and participant-reported outcome measures in women who switch from tenofovir disoproxil emtricitabine and a nonnucleoside reverse transcriptase inhibitor to abacavir, lamivudine and dolutegravir.

Author: CampbellLucy, IbrahimFowzia, BarbiniBirgit, SamarawickramaAmanda, OrkinChloe, FoxJulie, WatersLaura, GilleeceYvonne, TariqShema, PostFrank A,

Improved bone density
Reduced bone density

This study looked at changes in bone density in women who switched from tenofovir disoproxil fumarate (TDF) to abacavir. The study found that switching to abacavir did not lead to any significant changes in bone density.

Journal ArticleAn article published in an academic or professional journal that reports original research or scholarly analysis.
Randomized Controlled TrialA clinical trial that randomly assigns participants to treatment and control groups to evaluate the effects of an intervention.
Research Support, Non-U.S. Gov'tResearch funding provided by government agencies outside the United States.

Language : English

5.

Anti-HIV Drugs Cause Mitochondrial Dysfunction in Monocyte-Derived Macrophages.

Author: WallaceJennillee, GonzalezHemil, RajanReshma, NarasipuraSrinivas D, VirdiAmber K, OlaliArnold Z, NaqibAnkur, ArbievaZarema, Maienschein-ClineMark, Al-HarthiLena

HIV treatment
Comorbidity risk

This study examines the effects of combination antiretroviral therapy (cART) on primary human monocyte-derived macrophages, independent of HIV, finding that cART alters the macrophage phenotype, potentially contributing to increased susceptibility to comorbidities in persons living with HIV.

Journal ArticleAn article published in an academic or professional journal that reports original research or scholarly analysis.
Research Support, N.I.H., ExtramuralResearch funding provided by the NIH to external research institutions and researchers.

Language : English

7.

HIV-Tat Exacerbates the Actions of Atazanavir, Efavirenz, and Ritonavir on Cardiac Ryanodine Receptor (RyR2).

Author: AlomarFadhel A, TianChengju, BidaseeSean R, VennZachary L, SchroderEvan, PalermoNicholas Y, AlShabeebMohammad, EdagwaBenson J, PayneJason J, BidaseeKeshore R

Arrhythmias
SCD

HIV-Tat and antiretroviral drugs, including atazanavir, efavirenz, and ritonavir, can bind to and modulate the activity of type 2 ryanodine receptor (RyR2), a key regulator of cardiac function. This modulation might contribute to the increased risk of sudden cardiac death (SCD) in people living with HIV infection, especially those with inadequate viral suppression.

Journal ArticleAn article published in an academic or professional journal that reports original research or scholarly analysis.

Language : English

8.

Randomized comparison of renal effects, efficacy, and safety with once-daily abacavir/lamivudine versus tenofovir/emtricitabine, administered with efavirenz, in antiretroviral-naive, HIV-1-infected adults: 48-week results from the ASSERT study.

Author: PostFrank A, MoyleGraeme J, StellbrinkHans Jürgen, DomingoPere, PodzamczerDaniel, FisherMartin, NordenAnthony G, CavassiniMatthias, RiegerArmin, Khuong-JossesMarie-Aude, BrancoTeresa, PearceHelen C, GivensNaomi, VavroCindy, LimMichael L

Emtricitabine effective
Tenofovir effective
Tubular dysfunction risk

The study found that tenofovir/emtricitabine fixed-dose combination was associated with increased markers of tubular dysfunction compared to abacavir/lamivudine. Tenofovir/emtricitabine showed a significant difference in efficacy favoring it over abacavir/lamivudine.

Comparative StudyResearch that compares multiple groups/interventions to determine differences/similarities in outcomes/characteristics.
Journal ArticleAn article published in an academic or professional journal that reports original research or scholarly analysis.
Multicenter StudyResearch conducted in collaboration with multiple research institutions. It aims to collect a wide range of data and obtain more generalizable results.
Randomized Controlled TrialA clinical trial that randomly assigns participants to treatment and control groups to evaluate the effects of an intervention.
Research Support, Non-U.S. Gov'tResearch funding provided by government agencies outside the United States.

Language : English

10.

Sulfasalazine-induced drug reaction with eosinophilia and systemic symptoms (DRESS) with concomitant acute chikungunya virus infection: possible role of new viral trigger.

Author: SilAbheek, BhattacharjeeMoni Sankar, ChandraAtanu, PramanikJayasri Das

Chikungunya
DRESS
Sulfasalazine

This case report describes a patient with drug reaction with eosinophilia and systemic symptoms (DRESS) induced by sulfasalazine, a medication commonly used for inflammatory bowel disease. The patient also had coexisting chikungunya fever, making diagnosis challenging. The report highlights the rarity of sulfasalazine-induced DRESS and suggests that chikungunya virus could be a potential trigger for DRESS.

Case ReportsIn the medical field, a report that describes in detail a unique case, an unusual medical condition, or the effect of a treatment. Provides new insights and possibilities for treatment through individual patient cases.
Journal ArticleAn article published in an academic or professional journal that reports original research or scholarly analysis.

Language : English

13.

Abacavir causes leukocyte/platelet crosstalk by activating neutrophil P2X7 receptors thus releasing soluble lectin-like oxidized low-density lipoprotein receptor-1.

Author: Blanch-RuízMaria Amparo, Sánchez-LópezAinhoa, Ríos-NavarroCésar, Ortega-LunaRaquel, Collado-DíazVíctor, OrdenSamuel, Martínez-CuestaMaría Angeles, EspluguesJuan V, ÁlvarezÁngeles

Myocardial infarction
Platelet activation
Thrombosis

This study investigated the role of neutrophils in platelet activation, which precedes thrombosis. The findings suggest that abacavir, an antiretroviral drug used in HIV therapy, promotes thrombosis through P2X7 receptors and that the secretome of abacavir-treated neutrophils (SN<sub>ABC</sub>) contributes to platelet activation.

Journal ArticleAn article published in an academic or professional journal that reports original research or scholarly analysis.
Research Support, Non-U.S. Gov'tResearch funding provided by government agencies outside the United States.

Language : English

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