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Bilirubin is a yellow-orange pigment formed after the breakdown of red blood cells and is eliminated by the liver. It’s not only a sign of a bruise, it may provide cardiovascular benefits, according to an epidemiology study. A recent analysis of health data from different veterans-both with and without HIV infection, found that within normal ranges, higher levels of bilirubin in the blood were associated with lower rates of heart failure, heart attack and stroke.
Studies have shown that bilirubin may have beneficial effects, by acting as an antioxidant or interfering with atherosclerosis. The data from the veterans adds to this evidence, and specifically looks at people living with HIV and at an anti-HIV drug, atazanavir, known to elevate bilirubin. The researchers did not see an independent effect of atazanavir on cardiovascular risk.
Even if controlled by antiretroviral drugs, HIV infection has negative effects on cardiovascular health, researchers examined data from the Veterans Aging Cohort Study, a nationwide look at HIV infection, supported by the National Institutes of Health. VACS data included 31,418 HIV-positive and 66,987 HIV-negative veterans, almost all men and 48 percent African American. Their age was an average of 48 years.
The researchers divided study participants into four groups according to their bilirubin levels.
Higher levels of bilirubin meant lower risk of heart attack, heart failure or stroke. The group with the highest level of bilirubin had 76 percent of the risk for combined cardiovascular events as the group with the lowest level, with effects seen even in people without liver disease.
Atazanavir is a HIV protease inhibitor, and is designed to stop HIV from processing itself. It has a side effect on an enzyme in human cells that is necessary for the recycling of bilirubin. There are some indications that the drug has negative effects, balancing out the benefits of bilirubin
haleplushearty.org