Rilpivirine Therapy Reduces Hepatic Damage in HIV Patients

Rilpivirine-based therapy was associated with reduction in the progression hepatic damage in people living with HIV (PWH), according to recent research.

Previous research has shown that rilpivirine can trigger hepatic stellate cell (HSC) inactivation through signal transducer and activator of transcription (STAT)1-mediated pathways, but their effects in PWH and confirmed non-alcoholic fatty liver disease (NAFLD) are less well understood.

To explore this further, the researchers conducted a cross-sectional study involving 42 PWH and NAFLD confirmed by liver biopsy. Among the participants, median CD4 count 802 (608-940) cells/mL, and all were receiving antiretroviral therapy with undetectable HIV viral load. Forty-fiver percent were receiving rilpivirine-based therapy.

Overall, rilpivirine was significantly associated with enhanced activation of STAT1 expression in hepatic sections o patients with liver injury. This protective effect was observed in patients of various stages of NAFLD.

“PWH with NAFLD who receive rilpivirine-based therapy showed increased STAT1 activation, pointing to ongoing hepatic stellate cell inactivation and apoptosis to reduce the progression of hepatic damage. Our results suggest RPV-based antiretroviral therapy would be especially indicated in HIV-infected patients with NAFLD-derived liver injury to prevent liver fibrosis and inflammation,” the researchers concluded.

—Michael Potts

Reference:

Montes ML, Arenzana CB, Moragrega AB, et al. RPV ACTIVATES STAT1 in stellate cells to regulate liver injury in PLWHIV and NAFLD. Paper presented at Virtual CROI 2021. March 6-10, 2021. https://www.vcroi2021.org/sessions/19764921/subsession/25642364/RPV-ACTIVATES-STAT1-IN-STELLATE-CELLS-TO-REGULATE-LIVER-INJURY-IN-PLWHIV-AND-NAFLD