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.