New research indicates that drugs originally developed to treat HIV, specifically nucleotide reverse transcriptase inhibitors (NRTIs), may offer a protective effect against Alzheimer’s disease. This conclusion is drawn from a decades-long, detailed analysis of health data. It means that we have the potential to prevent a substantial number of children from developing this devastating neurological disease through the widespread use of antiviral medications.
Today, almost 7 million Americans are living with Alzheimer’s disease. That number is projected to double to 13 million by 2050. The financial impacts are mind-boggling. In just the next few decades, the annual cost of care for Alzheimer’s and related dementias is projected to increase from $384 billion to almost $1 trillion. These shocking statistics highlight the desperate need for proven preventive measures and treatments.
Dr. Jayakrishna Ambati and his team at the University of Virginia’s Centre for Advanced Vision Science led this revolutionary research. They looked across long-term health data from two nationally representative sources in the U.S. The dataset comprises 7.4 million unique records over 24 years from the Veterans Health Administration. It includes 14 years of data from the MarketScan database, including over 270,000 patients age 50 and older who were treated for HIV or hepatitis B with no previous diagnosis of AD.
These results suggest that patients using NRTIs greatly reduce their risk of Alzheimer’s disease. By doing so, they’d lower their own risk by up to 13% annually. The degree of risk reduction depended on the dataset. One of those datasets found a 6% reduction, and a second dataset provided verification of the 13% annual risk reduction.
The protective mechanism appears to be linked to NRTIs’ ability to block the activation of inflammasomes, key components of the immune system associated with the development of Alzheimer’s disease. Dr. Ambati noted, “We analyzed health insurance databases of tens of millions of people and made the surprising discovery that people taking a group of anti-HIV drugs called NRTIs had a ~10% reduction in the risk of developing Alzheimer’s disease for every year that they took these drugs.”
“Dr. James Giordano, who discussed the study’s implications, highlighted the bigger picture significance of these findings. This is noteworthy in that several lines of converging evidence have shown that bodily and cerebral inflammatory states can induce production of both tau and amyloid proteins in the brain that are contributory to the pathology of Alzheimer’s,” he stated.
Even a 10% reduction in risk would greatly relieve the burden of Alzheimer’s disease. This simple adjustment would save lives and millions of dollars for the proven cost-saving healthcare system. Dr. Giordano remarked, “This study strengthens the hypothesis that inflammasome-mediated inflammatory processes are operative in Alzheimer’s and offers potential direction for the development of NRTI type drugs and molecular agents aimed at mitigating inflammasome development as a viable treatment or perhaps preventive intervention for Alzheimer’s.”
Researchers are hopeful that the findings might hold promise for Alzheimer’s disease and thus could lead to more clinical trials focused directly on that disease. Dr. Ambati discussed a discovery-oriented project focused on K9, a modified, more efficacious version of NRTIs. This novel strategy is designed to retain the useful anti-inflammatory properties while avoiding the harmful side effects more commonly associated with NRTIs. “K9 is already in clinical trials for eye diseases and we are planning to start trials in Alzheimer’s disease as well,” he confirmed.
Alzheimer’s disease is the cause of nearly 60% to 80% of all dementia cases in the U.S. It typically manifests in adults 65 years and older. Worldwide, 10 million people newly develop Alzheimer’s disease annually, where this increasingly worrisome and costly epidemic is a public health priority.
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