Background: The association between abacavir use and increased risk of myocardial
infarction has been heavily debated, but cohort studies and randomized trials have provided conflicting
results. Aim of our study is to compare the effect of abacavir and tenofovir on the inflammation and
endothelial activation markers.
Methods: We performed an observational study of HIV-infected naïve patients starting
tenofovir/emtricitabine (group A) or abacavir/lamivudine (group B) plus efavirenz. In the present
analysis, we measured serum levels of high-sensitivity C-reactive protein (hsCRP), interleukin-6 (IL-6), tumor necrosis
factor-α (TNF-α), soluble vascular adhesion molecule-1 (VCAM-1), soluble intercellular adhesion molecule-1 (ICAM-1),
E-selectin and P-selectin at baseline and during a 48-week follow-up.
Results: As a whole, 118 patients (93 males; mean age ± SD of 42.8 ± 10.1 years) were enrolled: 61 in group A and 57 in
group B. In group A at weeks 24 and 48 the mean concentrations of IL-6, TNF-α, ICAM-1, VCAM-1, E-selectin and Pselectin
decreased significantly in comparison with respective baseline values. In group B at week 24 a significant
increase in mean values of these markers was reported in comparison with group A, but after 48 weeks they significantly
decreased in group B too and no significant differences between groups A and B were found.
Conclusion: In our study, naïve patients starting tenofovir/emtricitabine or abacavir/lamivudine plus efavirenz showed
after 48 weeks a significant and comparable decrease in serum concentrations of IL-6, TNF-α, ICAM-1, VCAM-1, Eselectin
and P-selectin, while the mean level of hs-CRP did not change significantly in any group.