Grant: Operating Grant

Recent research has shown that HIV may stimulate the immune system to generate a high degree of inflammation. This inflammation can be detected using specialized blood tests that measure molecules known as 'inflammatory markers'. Inflammation is important in HIV because it may shorten the time until treatment with highly active antiretroviral therapy (HAART) is needed. Inflammation also contributes to heart , kidney and liver disease. Little is known about these inflammatory markers in the early stages of HIV infection and among people not yet treated with HAART. In related research, Canadian researchers are leading two large clinical trials studying whether the anti-herpes drug valacyclovir (in the VALIDATE trial), or, a micronutrient/ antioxidant supplement (in the MAINTAIN trial), may be able to prolong the time before HAART is needed. One way these treatments might work is by decreasing inflammation. Objectives: 1.What are the levels of inflammatory markers in people with HIV who are not yet on HAART, and how do these levels change over time? 2.Can blood levels of specific inflammatory markers help predict when HAART will be needed? 3.Can the anti-herpes drug valacyclovir or micronutrient/antioxidant supplementation decrease blood levels of these inflammatory markers? 4.Does herpes type 2 infection increase inflammatory markers? 5.What is the effect of starting HAART on inflammatory markers? This research will provide important insights into the levels of inflammation in people with untreated HIV. The results will help determine whether these blood tests should be done routinely in all people living with HIV in Canada, to improve individual health by predicting how quickly HIV will lead to symptoms and other serious infections. This information will also contribute to the ongoing debate about the best time to start HAART. The analysis will be invaluable in interpreting the final results of the VALIDATE and MAINTAIN trials.