肝纤维化及其并发症已成为当前艾滋病病毒（HIV）感染者主要的疾病负担和死因。流行病学监测和临床观察性研究显示HIV感染者肝纤维化率和病情显著重于普通人群，但其病理机制尚未明确。近年研究提示HIV感染诱导和促使肠道微生物移位（MT），通过刺激炎性反应而促进多种慢性并发症发生发展。本项目拟采用前瞻性队列研究设计，以云南省德宏州650例新报告且合并肝纤维化的HIV感染者组成研究队列，入组基线调查后接受高效抗逆转录病毒治疗（HAART）和包括3次随访调查的持续3年的队列研究。通过定期调查和检测HBV和HCV感染状态、血液脂多糖（LPS）及其结合蛋白LBP等4种MT标志物及结缔组织生长因子（CTGF）等10种炎性细胞因子水平，掌握HIV感染者HAART下肝纤维化发展转归、MT及相关炎性反应的动态变化规律，探讨HAART下HIV感染者微生物移位与肝纤维化之间的关联及其炎性机制。

Liver fibrosis and related complications are currently the major disease burden and causes of death for HIV-infected patients. Epidemiological surveillance and clinical observational studies reveal that both incidence and disease progression of liver fibrosis are more severe in HIV-infected people than in general population. However, the pathogenic mechanisms are yet to be understood. Recent studies suggest that HIV infection stimulates and enhances intestinal microbial translocation (MT) which in turn stimulates inflammatory responses that are significantly associated with development of a variety of chronic complications. Therefore, using a prospective cohort study design in the proposed project, we aim to establish a cohort of 650 newly reported HIV-infected patients with liver fibrosis in Dehong prefecture of Yunnan province. Participants will receive highly active antiretroviral therapy (HAART) immediately after a baseline survey and will receive 3 consecutive follow-up surveys during a three-year follow-up observation period. Through the aforementioned periodic surveys including epidemiological questionnaire interviews, HBV and HCV testing, testing for blood MT biomarkers including lipopolysaccharides (LPS), LPS binding proteins such as LBP and MT-related inflammatory cytokines such as connective tissue growth factor (CTGF), we expect to determine dynamic changes of liver fibrosis progression, MT and related inflammatory responses before and after HAART, and to explore relationship between MT and liver fibrosis progression and its inflammatory mechanisms among HIV-infected patients under HAART.