Persistent microbial translocation and immune activation in HIV-1-infected south africans receiving combination antiretroviral therapy

Edana Cassol, Susan Malfeld, Phetole Mahasha, Schalk Van Der Merwe, Sharon Cassol, Chris Seebregts, Massimo Alfano, Guido Poli, Theresa Rossouw

Research output: Contribution to journalArticle

Abstract

Background. Microbial translocation contributes to immune activation and disease progression during chronic human immunodeficiency virus type 1 (HIV-1) infection. However, its role in the African AIDS epidemic remains controversial. Here, we investigated the relationship between markers of monocyte activation, plasma lipopolysaccharide (LPS), and HIV-1 RNA in South Africans prioritized to receive combination antiretroviral therapy (cART). Methods. Ten HIV-1-negative African controls and 80 HIV-1-infected patients with CD4 T cell counts +CD16+ monocyte levels were positively correlated with HIV-1 viremia. This finding, together with cART-induced normalization of these markers, suggests that their upregulation was driven by HIV-1. Plasma interleukin-6 was associated with the presence of opportunistic coinfections. Soluble CD14 and tumor necrosis factor were linked to plasma LPS levels and, as observed for LPS, remained elevated in patients receiving effective cART. Conclusions. Microbial translocation is a major force driving chronic inflammation in HIV-infected Africans receiving cART. Prevention of monocyte activation may be especially effective at enhancing therapeutic outcomes.

Original languageEnglish
Pages (from-to)723-733
Number of pages11
JournalJournal of Infectious Diseases
Volume202
Issue number5
DOIs
Publication statusPublished - Sep 1 2010

ASJC Scopus subject areas

  • Infectious Diseases
  • Immunology and Allergy

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