Effects of Sodium Restriction on Activation of the Renin-Angiotensin-Aldosterone System and Immune Indices During HIV Infection

Abstract

Background: Human immunodeficiency virus (HIV)-infected patients demonstrate increased activation of the renin-angiotensin-aldosterone system (RAAS). We evaluated changes in immune markers with physiological RAAS activation.

Methods: Immune activation markers were assessed serially in 18 HIV-infected and 7 non-HIV-infected subjects consuming an ad libitum diet followed by a standardized low-sodium diet.

Results: Levels of CCL-2 (P = .0004) and soluble CD163 (P = .0001) significantly increased with sodium restriction and RAAS activation, compared with levels in individuals with ad libitum sodium intake, among chronically treated HIV-infected subjects (mean duration of ART [±SEM], 11 ± 1 years), but not among non-HIV-infected subjects of similar age and sex.

Conclusions: Dietary sodium restriction, which activates RAAS, uniquely stimulates critical indices of immune activation during HIV infection.

Clinical trials registration: NCT01407237.

Keywords: HIV; immune activation; mineralocorticoid; renin-angiotensin-aldosterone system; sodium restriction.

© The Author 2016. Published by Oxford University Press for the Infectious Diseases Society of America. All rights reserved. For permissions, e-mail journals.permissions@oup.com.

Figures

Figure 1.

Comparison of the markers of immune activation CCL-2 and soluble CD163 during ad libitum and low-sodium diets in subjects with (A and C) and those without (B and D) human immunodeficiency virus (HIV) infection. Box plot represents the 25th and 75th percentiles, and lines within the boxes represents medians.