Antiretroviral therapy in HIV-infected elite controllers: impact on gut immunology, microbial translocation, and biomarkers of serious non-AIDS conditions.
Antiretroviral therapy in HIV-infected elite controllers: impact on gut immunology, microbial translocation, and biomarkers of serious non-AIDS conditions.
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DOI：
10.1097/qai.0000000000000359
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发表时间：
2014-12-15
期刊：
影响因子：
--
通讯作者：
Kaul R
中科院分区：
文献类型：
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作者：
Kim CJ;Kovacs C;Chun TW;Kandel G;Osborne BJ;Huibner S;Shahabi K;Yue FY;Benko E;Ostowski M;Kaul R
精英控制员(ECs)在没有抗逆转录病毒治疗(ART)的情况下保持无法检测到的艾滋病毒病毒载量，但他们患严重非艾滋病疾病(SNA)的风险增加。我们评估了血管内皮细胞中ART对肠道免疫功能障碍和预测SNA的生物标志物(血液CD4/CD8比率、血浆IL-6、D-二聚体水平)的影响。在基线时，与未感染HIV的对照组相比，ECs的IL-6和D-二聚体水平升高，而CD4/CD8比率降低，但在微生物易位或肠道CD4亚群方面没有差异。ART可提高CD_4/CD_8比值，但不能使IL-6和D-二聚体水平正常化。EC SNA的发病机制可能独立于肠道免疫功能障碍，其解决可能需要长期的抗逆转录病毒治疗。
Elite controllers (ECs) maintain undetectable HIV viral loads without antiretroviral therapy (ART), but are at increased risk of serious non-AIDS conditions (SNA). We assessed the impact of ART in ECs on gut immune dysfunction and biomarkers predicting SNA (blood CD4/CD8 ratio, plasma IL-6, D-dimer levels). At baseline, ECs had elevated IL-6 and D-dimer levels and reduced CD4/CD8 ratio compared to HIV-uninfected controls, but no difference in microbial translocation or gut CD4 subsets. ART increased CD4/CD8 ratio but did not normalize IL-6 and D-dimer levels. EC SNA pathogenesis may be independent of gut immune dysfunction, and resolution may require prolonged ART.