Abacavir Induces Arterial Thrombosis in a Murine Model

J Infect Dis. 2018 Jun 20;218(2):228-233. doi: 10.1093/infdis/jiy001.


Background: The purinergic system is known to underlie prothrombotic and proinflammatory vascular programs, making the profile of experimental actions demonstrated by abacavir compatible with thrombogenesis. However, direct evidence of a prothrombotic effect by the drug has been lacking.

Methods: The present study appraised the effects of abacavir in a well-validated animal model of arterial thrombosis. The role of ATP-P2X7 receptors in the actions of the drug was also assessed, and the actions of recognized vascular-damaging agents and other nucleoside reverse-transcriptase inhibitors (NRTIs) were evaluated and compared to those of abacavir.

Results: Abacavir dose-dependently promoted thrombus formation. This effect was reversed by a P2X7-receptor antagonist and was nonexistent in P2X7 knockout mice. The effects of abacavir were similar to those of diclofenac and rofecoxib. Other NRTIs had no thrombosis-related effects.

Conclusion: Abacavir promotes arterial thrombosis through interference with purinergic signaling, suggesting a possible biological mechanism for the clinical association of abacavir with cardiovascular diseases.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Animals
  • Anti-HIV Agents / administration & dosage
  • Anti-HIV Agents / adverse effects*
  • Dideoxynucleosides / administration & dosage
  • Dideoxynucleosides / adverse effects*
  • Disease Models, Animal
  • Dose-Response Relationship, Drug
  • Male
  • Mice, Knockout
  • Receptors, Purinergic P2X7 / metabolism
  • Thrombosis / chemically induced*


  • Anti-HIV Agents
  • Dideoxynucleosides
  • Receptors, Purinergic P2X7
  • abacavir