HIV-1 induces in vivo platelet activation by enhancing platelet NOX2 activity

- HIV-1 infection is associated with in vivo enhanced platelet oxidative stress.
- HIV-1 subjects disclosed enhanced platelet NOX2 activity and 8-iso-PGF2α formation.
- NOX2 activation and plasma levels of sCD40L were independently associated.
- HIV-1 patients showed a residual platelet oxidative stress despite effective cART.

SummaryObjectivesHIV-1 patients show increased platelet activation, but the mechanisms involved are not completely clarified. We speculated that HIV-1 might induce in vivo platelet activation by enhancing platelet NOX2-related oxidative stress.MethodsWe measured soluble CD40 Ligand (sCD40L), a systemic marker of platelet activation, in 36 HIV-1 patients under effective combined antiretroviral therapy (cART) and in 10 naïve HIV-1 subjects. As control, 20 healthy subjects (HS) were included. Platelet oxidative stress was measured by platelet NOX2-derived peptide (sNOX2-dp), p47phox translocation to platelet membrane and platelet prostaglandin F2α (8-iso-PGF2α).ResultssCD40L was increased both in HIV-1 naïve and cART patients compared to HS (p < 0.001). Platelet sNOX2-dp and 8-iso-PGF2α were significantly higher in HIV-1 naïve subjects compared to those on cART and to HS, and both were mutually correlated (R = 0.734, p < 0.001). A stepwise multivariable linear regression analysis showed that platelet sNOX2-dp (β: 0.803, p < 0.001), HIV-1 infection (β: 0.146, p = 0.014) and age (β: 0.166, p = 0.001) were independently associated to sCD40L levels.ConclusionsHIV-1 infection is associated with increased platelet oxidative stress, which was related to the activation of NOX2. The independent association between platelet NOX2 activation and plasma levels of sCD40L suggest that in vivo platelet activation may be dependent upon platelet oxidative stress.