Immune activation and neuroinflammation in alcohol use and HIV infection: evidence for shared mechanisms

Monnig, Mollie A.

doi:10.1080/00952990.2016.1211667

Cited by 32 publications

(19 citation statements)

References 189 publications

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“…4,7,9,[25][26][27] Furthermore, our analyses may be restricted by the lack of information on several unmeasured confounders in UK CHIC known to modulate immune responses, including infection by cytomegalovirus and other human herpesvirus, tobacco, and alcohol use. [28][29][30][31][32] Finally, the small number of new AIDS events in the study means that our analyses may be underpowered to detect some associations.…”

Section: Cd41:cd81 T Cell Ratio and Aids Risk On Artmentioning

confidence: 99%

CD4+:CD8+ T Cell Ratio Normalization and the Development of AIDS Events in People with HIV Starting Antiretroviral Therapy

Vivancos-Gallego

Hill

Sabin

2020

AIDS Research and Human Retroviruses

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We identify factors associated with the normalization of the CD4+:CD8+ T cell ratio among UK Collaborative HIV Cohort study participants, and describe the association of the CD4+ and CD8+ T cell counts and the CD4+:CD8+ T cell ratio, with the risk of new AIDS events among individuals who achieve a suppressed viral load. Participants initiating combination antiretroviral therapy (cART) after 2006 with a CD4+:CD8+ T cell ratio <1, and viral suppression within 6 months were included. Cox proportional hazard models were used to examine associations with ratio normalization (ratio ‡1). Poisson regression models were used to investigate factors associated with the development of AIDS after viral load suppression. A total of 13,178 participants [median age: 37 (interquartile range: 31-44)] were followed for 75,336 person-years. Of the 4,042 (32.9%) who experienced ratio normalization, individuals with a high CD4+ T cell count [>500 vs. £200 cells/mm 3 , adjusted hazard ratio (95% confidence interval): 7.93 (6.97-9.01)], low CD8+ T cell count [>1,150 vs. £500 cells/mm 3 : 0.18 (0.16-0.21)], and low CD4+:CD8+ T cell ratio [>0.8 vs. <0.2: 12.36 (10.41-14.68)] at cART initiation were more likely to experience ratio normalization. Four hundred and nineteen people developed a new AIDS event. Most recent CD4+ T cell count [>500 vs. £200 cells/mm 3 : adjusted rate ratio 0.24 (0.16-0.34)] and CD4+:CD8+ T cell ratio [>0.8 vs. <0.2: 0.33 (0.21-0.52)] were independently associated with a new AIDS event. One third of study participants experienced ratio normalization after starting cART. CD4+ T cell count and CD4+:CD8+ T cell ratio are both individually associated with ratio normalization and the development of new AIDS events after cART.

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Section: Cd41:cd81 T Cell Ratio and Aids Risk On Artmentioning

confidence: 99%

CD4+:CD8+ T Cell Ratio Normalization and the Development of AIDS Events in People with HIV Starting Antiretroviral Therapy

Vivancos-Gallego

Hill

Sabin

2020

AIDS Research and Human Retroviruses

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“… 9 , 10 Alcohol and other drug use also suppresses immune responses, 11 – 13 particularly among people living with HIV. 14 Along with underlying health conditions, substance use raises concerns for COVID-19 morbidity and mortality in people living with HIV. 15 High prevalence of substance use and co-occurring underlying health conditions have the potential to amplify the severity of COVID-19 in people living with HIV.…”

Section: Introductionmentioning

confidence: 99%

Intersecting Pandemics: Impact of SARS-CoV-2 (COVID-19) Protective Behaviors on People Living With HIV, Atlanta, Georgia

Kalichman

Eaton

Berman

et al. 2020

JAIDS Journal of Acquired Immune Deficiency Syndromes

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Background: COVID-19 and its social responses threaten the health of people living with HIV. We conducted a rapid-response interview to assess COVID-19 protective behaviors of people living with HIV and the impact of their responses on HIV-related health care. Method: Men and women living with HIV (N = 162) aged 20–37 years participating in a longitudinal study of HIV treatment and care completed routine study measures and an assessment of COVID-19–related experiences. Results: At baseline, most participants demonstrated HIV viremia, markers indicative of renal disorders, and biologically confirmed substance use. At follow-up, in the first month of responding to COVID-19, engaging in more social distancing behaviors was related to difficulty accessing food and medications and increased cancelation of health care appointments, both by self and providers. We observed antiretroviral therapy adherence had improved during the initial month of COVID-19 response. Conclusions: Factors that may pose added risk for COVID-19 severity were prevalent among people living with HIV, and those with greater risk factors did not practice more COVID-19 protective behaviors. Social distancing and other practices intended to mitigate the spread of COVID-19 interfered with HIV care, and impeded access to food and medications, although an immediate adverse impact on medication adherence was not evident. These results suggest social responses to COVID-19 adversely impacted the health care of people living with HIV, supporting continued monitoring to determine the long-term effects of co-occurring HIV and COVID-19 pandemics.

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“…HIV‐associated biomarker perturbations described above are paralleled in chronic heavy drinking, presumably due to the shared factor of microbial translocation (Monnig, ). Like HIV infection, heavy drinking alters the composition of the intestinal microbiome, depletes gut lymphocytes, and induces intestinal hyperpermeability via disruption of tight junction proteins (Asquith et al., ; Brenchley et al., ; Dinh et al., ; Keshavarzian et al., ; Mutlu et al., ; Nazli et al., ; Vazquez‐Castellanos et al., ).…”

mentioning

confidence: 99%

HIV Infection, HCV Coinfection, and Alcohol Use: Associations with Microbial Translocation and Immune Activation

Monnig

Cohen

Ramratnam

et al. 2019

Alcoholism Clin & Exp Res

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Background: Human immunodeficiency virus (HIV) infection and heavy drinking independently promote microbial translocation and inflammation. However, it is not known how alcohol use may affect these processes in people living with HIV (PLWH). This study tested the hypothesis that alcohol exacerbates innate immune dysfunction in PLWH.Methods: Participants were 75 PLWH and 34 uninfected controls. Groups were recruited to have similar proportions of nondrinkers, moderate drinkers, and heavy drinkers. Substance use data and plasma samples were collected at up to 3 visits over a 5-year study period. Recent alcohol use was assessed with the Timeline Followback Interview. Biomarkers of microbial translocation (lipopolysaccharide, LPS) and immune activation (lipopolysaccharide binding protein, LBP; soluble CD14, sCD14; soluble CD163, sCD163) were quantified using enzyme-linked immunosorbent assays. Analyses tested 2 hypotheses: (i) that biomarker levels would be significantly higher in PLWH than controls with comparable alcohol use and (ii) that current alcohol use would exacerbate biomarker elevations in PLWH. The second analysis included the interaction of alcohol use with hepatitis C virus (HCV) coinfection.Results: Groups were matched on alcohol use, smoking, and other drug use. All biomarkers were significantly higher in PLWH relative to controls (LBP: p = 0.005; LPS: p = 0.014; sCD14: p < 0.001; sCD163: p < 0.001). In PLWH, alcohol use showed a significant, positive association with sCD163, but not with other biomarkers. However, the interaction of alcohol use with HCV coinfection was significant for all biomarkers (LBP: p = 0.002; LPS: p = 0.026; sCD14: p = 0.0004; sCD163: p = 0.001). In pairwise tests with sequential Bonferroni correction, HIV/HCV coinfected individuals who drank heavily had significantly higher sCD163 compared to coinfected nondrinkers and to HIV monoinfected nondrinkers, moderate drinkers, and heavy drinkers (ps < 0.005). Coinfected moderate drinkers had significantly higher sCD163 than each monoinfected group (ps < 0.003). In addition, sCD14 was significantly higher in coinfected moderate drinkers than coinfected nondrinkers (p = 0.027).Conclusions: As predicted, PLWH had higher levels of LBP, LPS, sCD14, and sCD163 than uninfected individuals with similar alcohol use. In PLWH, alcohol by itself was significantly associated only with higher sCD163. However, heavy or moderate alcohol use was associated with elevations in macrophage activation (sCD163) and monocyte activation (sCD14) in HIV/HCV coinfected individuals.

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Immune activation and neuroinflammation in alcohol use and HIV infection: evidence for shared mechanisms

Cited by 32 publications

References 189 publications

CD4+:CD8+ T Cell Ratio Normalization and the Development of AIDS Events in People with HIV Starting Antiretroviral Therapy

CD4+:CD8+ T Cell Ratio Normalization and the Development of AIDS Events in People with HIV Starting Antiretroviral Therapy

Intersecting Pandemics: Impact of SARS-CoV-2 (COVID-19) Protective Behaviors on People Living With HIV, Atlanta, Georgia

HIV Infection, HCV Coinfection, and Alcohol Use: Associations with Microbial Translocation and Immune Activation

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