Evaluation of HIV-DNA and inflammatory markers in HIV-infected individuals with different viral load patterns

Falasca, Francesca; Carlo, Daniele Di; Vito, Corrado De; Bon, Isabella; d’Ettorre, Gabriella; Fantauzzi, Alessandra; Mezzaroma, Ivano; Fimiani, Caterina; Re, Maria Carla; Vullo, Vincenzo; Antonelli, Guido; Turriziani, Ombretta

doi:10.1186/s12879-017-2676-2

Cited by 38 publications

(28 citation statements)

References 40 publications

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“…However, the correlations between such markers and the degree of viral suppression have not been thoroughly explored. Two studies observed no association between LLV and CRP levels , whereas conflicting results regarding sCD14 levels have been reported . We hypothesized that LLV could trigger persistent inflammation and coagulation cascades and that this in turn may contribute to progression of atherosclerosis in PLHIV.…”

Section: Introductionmentioning

confidence: 89%

Is low‐level HIV‐1 viraemia associated with elevated levels of markers of immune activation, coagulation and cardiovascular disease?

et al. 2019

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Objectives The clinical significance of low‐level viraemia (LLV) during antiretroviral therapy (ART) is debated. We retrospectively investigated longitudinal levels of plasma markers associated with inflammation, altered coagulation and cardiovascular disease in Swedish HIV‐positive adults in relation to LLV or permanent virological suppression during long‐term ART. Methods Plasma levels of C‐reactive protein (CRP), D‐dimer, vascular cell adhesion molecule 1 (VCAM‐1), suppression of tumorigenicity 2 (ST2), growth differentiation factor 15 (GDF‐15), soluble CD14 (sCD14), soluble CD163 (sCD163), interferon‐γ‐induced protein 10 (IP‐10) and β‐2‐microglobulin were measured in 34 individuals with LLV (viral load 50–999 HIV‐1 RNA copies/mL) and in matched controls with persistent virological suppression. Biomarker levels were analysed in samples obtained during episodes of LLV and follow‐up samples obtained 1 year later (with similar timing for controls). All biomarkers were analysed using an independent sample t‐test and analysis of covariance (ANCOVA) after logarithmic transformation. Log‐rank analysis was applied for markers with concentration values out of range. Results Compared with controls, patients with LLV had significantly higher levels of GDF‐15 [geometric mean 3416 (95% confidence interval (CI) 804–14 516) pg/mL versus 2002 (95% CI 355–11 295) pg/mL in controls; P = 0.026] and D‐dimer [mean 1114 (95% CI 125–9917) ng/mL versus 756 (95% CI 157–3626) ng/mL; P = 0.038] after adjustment for age, CD4 count nadir and type of ART. In the unadjusted t‐test, only GDF‐15 was significantly higher and in the log‐rank test, both GDF‐15 and D‐dimer were significantly elevated. No significant differences were observed for the other biomarkers analysed. Conclusions Although levels of inflammation markers were similar in ART recipients with and without LLV, persons with LLV had significantly higher levels of GDF‐15 and D‐dimer. These findings suggest a potential link between LLV and cardiovascular outcomes.

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Section: Introductionmentioning

confidence: 89%

Is low‐level HIV‐1 viraemia associated with elevated levels of markers of immune activation, coagulation and cardiovascular disease?

et al. 2019

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“…Blood and faecal samples were collected from each subject included in the study and submitted to the quantitative measurements of CD4+ T-lymphocytes and viral load [26], and to the microscopic observation of the wet smears stained with Lugol, directly or after Ridley concentration [27], respectively. Genomic DNA was then extracted from stool samples and submitted to PCR amplification using primers previously described [28], which target a fragment of about 600 bp from the Blastocystis -SSU rRNA gene, following PCR protocol and conditions described in Mattiucci et al, 2016 [13].…”

Section: Methodsmentioning

confidence: 99%

Molecular characterization of Blastocystis subtypes in HIV-positive patients and evaluation of risk factors for colonization

et al. 2019

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BackgroundBlastocystis is one of the most common intestinal protozoa in human faecal samples with uncertain impact on public health. Studies on the prevalence of Blastocystis in HIV-positive patients are limited and dated.MethodsA cross-sectional study was carried out involving 156 HIV-positive patients to evaluate the prevalence of Blastocystis-subtypes by molecular amplification and sequencing the small subunit rRNA gene (SSU rDNA), to identify the risk factors for its transmission, to examine the relationship between the presence of the protist and gastrointestinal disorders. Furthermore, the evaluation of the faecal calprotectin by immunoassay from a sample of subjects was performed to evaluate the gut inflammation in Blastocystis-carriers.ResultsBlastocystis-subtypes ST1, ST2, ST3, ST4 were identified in 39 HIV-positive patients (25%). No correlation was found between the presence of the protist and virological or epidemiological risk factors. Blastocystis was more frequently detected in homosexual subjects (p = 0.037) infected by other enteric protozoa (p = 0.0001) and with flatulence (p = 0.024). No significant differences in calprotectin level was found between Blastocystis-carriers and free ones.ConclusionsBlastocystis is quite common in HIV-positive patients on ART showing in examined patients 25% prevalence. Homosexual behaviour may represent a risk factor for its transmission, while CD4 count and viremia didn’t correlate with the presence of the protist. The pathogenetic role of Blastocystis remains unclear and no gut inflammation status was detected in Blastocystis-carriers. The only symptom associated with Blastocystis was the flatulence, evidencing a link between the presence of the protist and the composition and stability of gut microbiota.

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“…Many authors have looked for correlations between markers of immune activation and HIV RNA level in virological responders, with inconsistent results. Some studies have reported links between, for example, markers of inflammation (TNF α , IL‐6), of monocyte activation (soluble CD14) or T cell activation (HLA‐DR, CD38), as well as exhaustion (PD‐1) on one hand, and viral load on the other hand. Yet, other studies did not observe these correlations .…”

Section: The Issue Of Inflammation and Immune Activationmentioning

confidence: 99%

Two‐drug vs. three‐drug combinations for HIV‐1: Do we have enough data to make the switch?

et al. 2019

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Three‐drug combination antiretroviral therapy (ART) became available in 1996, dramatically improving the prognosis of people living with HIV. The clinical benefits of ART are due to the sustained viral load suppression and CD4 T cell gains. Major drawbacks of the first ART regimens were adverse events, and high pill burden, which led to the reduction of drug adherence resulting in frequent treatment discontinuations and the development of drug resistance. Due to increased viral potency of new antiretroviral drugs consideration of a two‐drug combination therapy repositioning occurred in an effort to reduce adverse events, drug‐drug interactions and cost, while maintaining a sustained antiviral effect. Various combinations of two‐drug regimens have been studied, and non‐inferiority compared to a three‐drug regimen has been shown only for some of them. In addition, a two‐drug combination regimen may not be suitable for every patient, especially those who are pregnant, those with tuberculosis or coexisting HBV infection. Furthermore no information has been generated concerning the secondary transmission of HIV from patients who have undetectable plasma viral load on two‐drug regimens. Additional studies of two‐drug combinations are also necessary to evaluate the debated existence of low viral replication in tissues and on immune activation. While there is no urgent need to routinely switch patients to two‐drug combination therapy, due to the availability of drug combinations without significant toxicities, dual regimens represent a suitable option that deserve long‐term evaluation before being introduced to clinical practice.

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Evaluation of HIV-DNA and inflammatory markers in HIV-infected individuals with different viral load patterns

Cited by 38 publications

References 40 publications

Is low‐level HIV‐1 viraemia associated with elevated levels of markers of immune activation, coagulation and cardiovascular disease?

Is low‐level HIV‐1 viraemia associated with elevated levels of markers of immune activation, coagulation and cardiovascular disease?

Molecular characterization of Blastocystis subtypes in HIV-positive patients and evaluation of risk factors for colonization

Two‐drug vs. three‐drug combinations for HIV‐1: Do we have enough data to make the switch?

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