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Alzheimer’s disease (AD) is one of the leading causes of dementia globally, with its increasing prevalence placing a heavy burden on caregivers, families, and society. Although efforts to better understand the disease are ongoing, more effective treatments are still required.
In recent advancements, scientists from the University of Virginia have found that people taking NRTIs, a class of drugs commonly used for treating HIV, may have a significantly lower risk of developing Alzheimer’s disease. This unexpected link may open a promising new direction for Alzheimer’s treatment.
What inspired this research?
Researchers had previously discovered that nucleoside reverse transcriptase inhibitors (NRTIs), drugs used for treating Hepatitis B and HIV, also block inflammasome activation—an immune response that is linked to Alzheimer’s progression. This discovery encouraged them to further investigate whether NRTIs could potentially slow down the progression of the disease.
“It’s estimated that over 10 million people around the world develop Alzheimer’s disease annually,” said Ambati, founding director of UVA’s Centre for Advanced Vision Science and the DuPont Guerry III Professor in the University of Virginia School of Medicine’s Department of Ophthalmology. “Our results suggest that taking these drugs could prevent approximately 1 million new cases of Alzheimer’s disease every year.”
How was the link discovered?
In the latest study, the team of UVA scientists analyzed 24 years of data from the U.S. Veterans Health database and 14 years of data from MarketScan, from which they selected patients who met the following criteria:
Aged 50 or older
Diagnosed with either Hepatitis B or HIV
Had been prescribed at least one NRTI
Had no prior diagnosis of Alzheimer’s disease
These patients were then compared to non-NRTI patients to track whether they later developed Alzheimer’s. To minimise potential bias, both groups were matched based on age, race, and health conditions like diabetes, hypertension, depression, Parkinson’s, and other factors known to influence Alzheimer’s risk.
From curiosity to outcome
After analyzing a combined database of approximately 270,000 patients, they found a 6% reduction in the hazard of developing AD in the Veterans Health group, whereas there was a 13% reduction in the case of MarketScan. Importantly, scientists found that exposure to other anti-HIV drugs did not show the same results, further reinforcing that NRTIs in particular are effective for this.
What’s next?
A small clinical trial of Lamivudine, a type of NRTI, has already shown promising results by reducing inflammation in participants after six months. However, further clinical trials on humans are required to fully support the use of these drugs. The study also noted that NRTIs may have side effects such as lactic acidosis, which, though rare, can be potentially fatal. Fortunately, derivatives like K-9 have already been developed, offering the same benefits without causing toxicity.
Reference:
1. Magagnoli, Joseph, Ambati, Meenakshi et al. “Association of nucleoside reverse transcriptase inhibitor use with reduced risk of Alzheimer's disease,” Alzheimer’s & Dementia: the journal of the Alzheimer’s Association 21, no. 5 (May 2025).https://doi.org/10.1002/alz.70180
(Input from various sources)
(Rehash/Pooja Bansal/MSM)
