Journal
JAIDS-JOURNAL OF ACQUIRED IMMUNE DEFICIENCY SYNDROMES
Volume 67, Issue 5, Pages 514-518Publisher
LIPPINCOTT WILLIAMS & WILKINS
DOI: 10.1097/QAI.0000000000000359
Keywords
HIV; elite controllers; antiretroviral therapy; gut immunology; microbial translocation; serious non-AIDS conditions; inflammation
Categories
Funding
- Ontario HIV Treatment Network [ROGB-G123]
- Canadian Institutes of Health Research/Canadian Digestive Health Foundation (CIHR/CDHF)
- CIHR (Emerging HIV Team Grant) [HET85518]
- Canadian Research Chair Program
- Intramural Research Program of the National Institutes of Allergy and Infectious Diseases, National Institute of Health
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Elite controllers (ECs) maintain undetectable HIV viral loads without antiretroviral therapy (ART) but are at increased risk of serious non-AIDS conditions (SNA). We assessed the impact of ART in ECs on gut immune dysfunction and biomarkers predicting SNA (blood CD4/CD8 ratio, plasma IL-6, D-dimer levels). At baseline, ECs had elevated IL-6 and D-dimer levels and reduced CD4/CD8 ratio compared with HIV-uninfected controls, but no difference in microbial translocation or gut CD4 subsets. ART increased CD4/CD8 ratio but did not normalize IL-6 and D-dimer levels. EC SNA pathogenesis may be independent of gut immune dysfunction, and resolution may require prolonged ART.
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