Document Detail

Low-level HIV viremia is associated with microbial translocation and inflammation.
MedLine Citation:
PMID:  23018379     Owner:  NLM     Status:  MEDLINE    
BACKGROUND: Decrease in HIV viral load (VL) is accompanied by decrease in microbial translocation (MT) and chronic inflammation, but the behavior of these markers in patients with HIV-VL <20 copies per milliliter is unknown. The aim of this study was to determine whether strict control of HIV-VL is associated with MT and chronic inflammation.
METHODS: Observational cross-sectional study.
INCLUSION CRITERIA: HIV patients receiving antiretroviral therapy and HIV-VL <200 copies per milliliter for more than 6 months.
EXCLUSION CRITERIA: chronic liver disease, active infection, or antibiotic consumption. Recruitment: patients who consecutively visited the outpatient clinic in November 2011. Primary endpoint: molecular MT as determined by detection in plasma of 16S ribosomal DNA. Secondary variables: lipopolysaccharide, soluble CD14, tumor necrosis factor α, and interleukin 6. Primary explanatory variable: HIV-VL (COBAS AmpliPrep/COBAS TaqMan HIV-1 test, version 2.0) with a detection limit of 20 copies per milliliter.
RESULTS: Fifty-two patients were included: 65% men, median age 45 years, HIV acquired predominantly through sex (75%), 40% Centers for Disease Control and Prevention stage C, and median CD4 lymphocyte count 552 cells per cubic millimeter (range, 126-1640 cells/mm). Molecular MT was observed in 46% and 18% of patients with low-level (20-200 copies/mL) and negative (<20 copies/mL) HIV-VL, respectively (P < 0.05). Plasma levels of inflammatory markers (tumor necrosis factor α and interleukin 6) were higher in patients with molecular MT (P < 0.01) and were not influenced for HIV-VL.
CONCLUSIONS: Patients with HIV infection receiving treatment and negative HIV-VL (<20 copies/mL) present less frequently MT than patients with low-level HIV viremias (20-200 copies/mL). MT is associated with higher levels of inflammation markers, independent of HIV-VL.
Sergio Reus; Joaquín Portilla; José Sánchez-Payá; Livia Giner; Rubén Francés; José Such; Vicente Boix; Esperanza Merino; Adelina Gimeno
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Publication Detail:
Type:  Journal Article; Research Support, Non-U.S. Gov't    
Journal Detail:
Title:  Journal of acquired immune deficiency syndromes (1999)     Volume:  62     ISSN:  1944-7884     ISO Abbreviation:  J. Acquir. Immune Defic. Syndr.     Publication Date:  2013 Feb 
Date Detail:
Created Date:  2013-01-18     Completed Date:  2013-03-08     Revised Date:  2014-07-31    
Medline Journal Info:
Nlm Unique ID:  100892005     Medline TA:  J Acquir Immune Defic Syndr     Country:  United States    
Other Details:
Languages:  eng     Pagination:  129-34     Citation Subset:  IM; X    
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MeSH Terms
Anti-Retroviral Agents / therapeutic use
Antigens, CD14 / blood
Bacterial Translocation*
Biological Markers / blood
CD4 Lymphocyte Count
Chi-Square Distribution
Chronic Disease
Cross-Sectional Studies
DNA, Bacterial / blood
DNA, Ribosomal / blood
HIV Infections / drug therapy,  immunology,  virology*
Inflammation / blood*,  complications,  virology
Interleukin-6 / blood
Lipopolysaccharides / blood
Middle Aged
Ribosomal Proteins / genetics
Risk Factors
Statistics, Nonparametric
Tumor Necrosis Factor-alpha / blood
Viral Load*
Viremia / complications,  virology*
Young Adult
Reg. No./Substance:
0/Anti-Retroviral Agents; 0/Antigens, CD14; 0/Biological Markers; 0/DNA, Bacterial; 0/DNA, Ribosomal; 0/Interleukin-6; 0/Lipopolysaccharides; 0/Ribosomal Proteins; 0/Rps16 protein, human; 0/Tumor Necrosis Factor-alpha
Comment In:
Antivir Ther. 2013;18(6):837-8   [PMID:  23732822 ]

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