Document Detail


Kinetics of microbial translocation markers in patients on efavirenz or lopinavir/r based antiretroviral therapy.
MedLine Citation:
PMID:  23383047     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
OBJECTIVES: We investigated whether there are differences in the effects on microbial translocation (MT) and enterocyte damage by different antiretroviral therapy (ART) regimens after 1.5 years and whether antibiotic use has impact on MT. In a randomized clinical trial (NCT01445223) on first line ART, patients started either lopinavir/r (LPV/r) (n = 34) or efavirenz (EFV) containing ART (n = 37). Lipopolysaccharide (LPS), sCD14, anti-flagellin antibodies and intestinal fatty acid binding protein (I-FABP) levels were determined in plasma at baseline (BL) and week 72 (w72).
RESULTS: The levels of LPS and sCD14 were reduced from BL to w72 (157.5 pg/ml vs. 140.0 pg/ml, p = 0.0003; 3.13 ug/ml vs. 2.85 ug/ml, p = 0.005, respectively). The levels of anti-flagellin antibodies had decreased at w72 (0.35 vs 0.31 [OD]; p<0.0004), although significantly only in the LPV/r arm. I-FABP levels increased at w72 (2.26 ng/ml vs 3.13 ng/ml; p<0.0001), although significantly in EFV treated patients only. Patients given antibiotics at BL had lower sCD14 levels at w72 as revealed by ANCOVA compared to those who did not receive (Δ = -0.47 µg/ml; p = 0.015).
CONCLUSIONS: Markers of MT and enterocyte damage are elevated in untreated HIV-1 infected patients. Long-term ART reduces the levels, except for I-FABP which role as a marker of MT is questionable in ART-experienced patients. Why the enterocyte damage seems to persist remains to be established. Also antibiotic usage may influence the kinetics of the markers of MT.
TRIAL REGISTRATION: ClinicalTrials.gov NCT01445223.
Authors:
Jan Vesterbacka; Piotr Nowak; Babilonia Barqasho; Samir Abdurahman; Jessica Nyström; Staffan Nilsson; Hiroyuki Funaoka; Tatsuo Kanda; Lars-Magnus Andersson; Magnus Gisslèn; Anders Sönnerborg
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Publication Detail:
Type:  Journal Article; Randomized Controlled Trial; Research Support, Non-U.S. Gov't     Date:  2013-01-28
Journal Detail:
Title:  PloS one     Volume:  8     ISSN:  1932-6203     ISO Abbreviation:  PLoS ONE     Publication Date:  2013  
Date Detail:
Created Date:  2013-02-05     Completed Date:  2013-07-19     Revised Date:  2014-02-06    
Medline Journal Info:
Nlm Unique ID:  101285081     Medline TA:  PLoS One     Country:  United States    
Other Details:
Languages:  eng     Pagination:  e55038     Citation Subset:  IM    
Data Bank Information
Bank Name/Acc. No.:
ClinicalTrials.gov/NCT01445223
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MeSH Terms
Descriptor/Qualifier:
Adult
Aged
Anti-Bacterial Agents / pharmacology
Anti-HIV Agents / pharmacology,  therapeutic use*
Antibodies, Bacterial / immunology,  metabolism
Antigens, CD14 / chemistry,  metabolism
Bacteria / drug effects*,  immunology,  metabolism
Benzoxazines / pharmacology,  therapeutic use*
Biological Markers / metabolism
CD4-Positive T-Lymphocytes / drug effects,  immunology
Drug Combinations
Fatty Acid-Binding Proteins / metabolism
Female
Flagellin / immunology
HIV-1 / drug effects,  physiology
Humans
Kinetics
Lipopolysaccharides / metabolism
Lopinavir / pharmacology,  therapeutic use*
Male
Middle Aged
Movement / drug effects*
Solubility
Time Factors
Viral Load / drug effects
Young Adult
Chemical
Reg. No./Substance:
0/Anti-Bacterial Agents; 0/Anti-HIV Agents; 0/Antibodies, Bacterial; 0/Antigens, CD14; 0/Benzoxazines; 0/Biological Markers; 0/Drug Combinations; 0/Fatty Acid-Binding Proteins; 0/Lipopolysaccharides; 12777-81-0/Flagellin; 2494G1JF75/Lopinavir; JE6H2O27P8/efavirenz
Comments/Corrections

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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