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Publication Details
AFRICAN RESEARCH NEXUS
SHINING A SPOTLIGHT ON AFRICAN RESEARCH
medicine
Persistent microbial translocation and immune activation in HIV-1-infected south africans receiving combination antiretroviral therapy
Journal of Infectious Diseases, Volume 202, No. 5, Year 2010
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Description
Background. Microbial translocation contributes to immune activation and disease progression during chronic human immunodeficiency virus type 1 (HIV-1) infection. However, its role in the African AIDS epidemic remains controversial. Here, we investigated the relationship between markers of monocyte activation, plasma lipopolysaccharide (LPS), and HIV-1 RNA in South Africans prioritized to receive combination antiretroviral therapy (cART). Methods. Ten HIV-1-negative African controls and 80 HIV-1-infected patients with CD4 T cell counts <200 cells/mL were sampled prior to (n=60 ) or during (n=20 ) receipt of effective cART. Viral load was measurenp60 np20 d by Nuclisens; LPS by the Limulus amoebocyte lysate assay; monocyte and T cell subsets by flow cytometry; and soluble CD14, cytokines, and chemokines by enzyme-linked immunosorbent assay and customized Bio-Plex plates. Results. Three distinct sets of markers were identified. CCL2, CXCL10, and CD14+CD16+ monocyte levels were positively correlated with HIV-1 viremia. This finding, together with cART-induced normalization of these markers, suggests that their upregulation was driven by HIV-1. Plasma interleukin-6 was associated with the presence of opportunistic coinfections. Soluble CD14 and tumor necrosis factor were linked to plasma LPS levels and, as observed for LPS, remained elevated in patients receiving effective cART. Conclusions. Microbial translocation is a major force driving chronic inflammation in HIV-infected Africans receiving cART. Prevention of monocyte activation may be especially effective at enhancing therapeutic outcomes. © 2010 by the Infectious Diseases Society of America.
Authors & Co-Authors
Cassol, Edana
Italy, Milan
Irccs Ospedale San Raffaele
Italy, Milan
Università Vita-salute San Raffaele
United States, Boston
Dana-farber Cancer Institute
Malfeld, Susan C.K.
Unknown Affiliation
Mahasha, Phetole Walter
Unknown Affiliation
van der Merwe, Schalk Willem
South Africa, Pretoria
University of Pretoria
Cassol, Sharon A.
Unknown Affiliation
Seebregts, Christopher John
South Africa, Tygerberg
South African Medical Research Council
Alfano, Massimo
Italy, Milan
Irccs Ospedale San Raffaele
Poli, Guido
Italy, Milan
Irccs Ospedale San Raffaele
Italy, Milan
Università Vita-salute San Raffaele
Rossouw, Theresa Marié
Unknown Affiliation
Statistics
Citations: 207
Authors: 9
Affiliations: 6
Identifiers
Doi:
10.1086/655229
ISSN:
00221899
Research Areas
Cancer
Infectious Diseases