HIV is an independent risk factor for lung disease, including chronic obstructive pulmonary disease (COPD) and emphysema. Angiotensin receptor blockers may be beneficial in COPD and emphysema through pathways that have been implicated in HIV-related lung disease. We performed a randomized comparison of the effects of losartan versus placebo on the plasma concentrations of the pneumoproteins, surfactant protein D (SPD) and club cell secretory protein (CCSP), in people living with HIV (PLWH). A total of 108 PLWH were included (52 assigned to losartan and 56 assigned to placebo). We found no difference in the change from baseline in log2 concentrations of CCSP or SPD over 1 year of follow-up. For SPD, we found a strong interaction by CD4+ counts, where those with CD4+ counts >350 cells/mm3 treated with losartan had more reduction (improvement) in SPD concentration than those treated with placebo (p value for interaction <.001). In conclusion, we did not find a beneficial effect of losartan on pneumoprotein concentrations in PLWH, but PLWH with higher CD4+ counts may have improvement in SPD when treated with losartan.
Bibliographical noteFunding Information:
This study was funded by a grant from the NIH National Institute on Aging (NIA/NIH: R01 AG045032). Study drug was provided by Merck Pharmaceuticals. D.M.M. was supported by the University of Minnesota T32 Training in Lung Science training grant (NHLBI: T32 HL007741). I.S. was supported by the intramural research program of NIAID/ NIH. K.M.K. was supported by resources and the use of facilities at the Minneapolis VA Health Care System (Minneapolis, MN).
© Copyright 2022, Mary Ann Liebert, Inc., publishers 2022.
- angiotensin receptor antagonists
- lung diseases
- pulmonary surfactant-Associated protein D
PubMed: MeSH publication types
- Journal Article
- Randomized Controlled Trial
- Research Support, N.I.H., Extramural
- Research Support, N.I.H., Intramural