Circulating (1→3)-β-D-Glucan as an immune activation marker decreased after ART in people living with HIV

Background: Plasma level of polysaccharide (1 -> 3)-beta-D-Glucan (beta DG), as a diagnostic marker of invasive fungal infection has been reported to be elevated in people living with HIV (PLWH). We assessed the association of circulating beta DG to inflammation and systemic immune activation and the effect of antiretroviral therapy (ART) on beta DG in PLWH. Method: Plasma and peripheral blood monocular cell samples from 120 PLWH naive to ART and after 1 year's ART were collected. Plasma levels of beta DG, markers of bacterial translocation, gut damage, and cellular immune activation were quantified. Result: The plasma beta DG levels were negatively correlated with CD4+ T cells count (r = -0.25, p = 0.005) and positively with HIV viral toad (r = 0.28, p = 0.002) before ART. It was also positively correlated with immune activation markers, including PD-1 expression on CD4+ T cell (r = 0.40, p = 0.01) and CD8+ T cell (r = 0.47, p = 0.002), as welt as HLADR+CD38+ co-expression on CD8+ T cell (r = 0.56, p = 0.0002), but not with the plasma levels of LPS (r = 0.02, p = 0.84), LPS binding protein (LBP, r = 0.11, p = 0.36), soluble LPS receptor sCD14 (r = 0.04, p = 0.68), intestinal fatty acid binding protein (IFABP, r = -0.12, p = 0.18), and regenerating islet-derived protein 3 alpha (REG3 alpha, r = 0.18, p = 0.06). After 1 year's ART, the levels of fsDG were significantly decreased compared to that in pre-ART (1.31 +/- 0.24 Log10 pg/ml vs. 1.39 0.18 Log10 pg/ml, p < 0.001). Conclusion: The level of plasma beta DG was associated with cellular immune activation and decreased after ART in PLWH, suggesting it could serve as a biomarker of immune activation and efficacy monitoring.

Automated summary

This study assessed the association of plasma beta DG levels with inflammation and immune activation in people living with HIV (PLWH) and the effect of antiretroviral therapy (ART) on beta DG levels. The results showed that beta DG levels were positively correlated with immune activation markers and decreased significantly after 1 year of ART, suggesting it could serve as a biomarker of immune activation and efficacy monitoring in PLWH.