Microbial Translocation and Cardiometabolic Risk Factors in HIV Infection

Trøseid, Marius; Manner, Ingjerd W.; Pedersen, Kim Steenstrup; Haissman, Judith M.; Kvale, Dag; Nielsen, Susanne Dam

doi:10.1089/aid.2013.0280

Cited by 40 publications

(34 citation statements)

References 131 publications

(133 reference statements)

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“…All these mechanisms are incompletely understood and are the focus of active research. Other pathogens, such as cytomegalovirus, might also contribute to this T-cell activation [87].…”

Section: The Role Of Hiv Infection In Itself In the Pathogenesis Of Cmentioning

confidence: 99%

“…Markers of microbial translocation correlate with markers of inflammation (such as hsCRP and IL-6), innate immune activation (such as sCD14 and sCD163), and coagulation (d-dimer) which are elevated in HIV-infected individuals and are predictive of morbidity (including CVD) and mortality [87][88][89][90][91][92].…”

Section: The Role Of Hiv Infection In Itself In the Pathogenesis Of Cmentioning

confidence: 99%

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Risk of Cardiovascular Disease in an Aging HIV Population: Where Are We Now?

2015

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With more effective and widespread antiretroviral treatment, the overall incidence of AIDS- or HIV-related death has decreased dramatically. Consequently, as patients are aging, cardiovascular disease (CVD) has emerged as an important cause of morbidity and mortality in the HIV population. The incidence of CVD overall in HIV is relatively low, but it is approximately 1.5-2-fold higher than that seen in age-matched HIV-uninfected individuals. Multiple factors are believed to explain this excess in risk such as overrepresentation of traditional cardiovascular risk factors (particularly smoking), toxicities associated with cumulative exposure to some antiretroviral agents, together with persistent chronic inflammation, and immune activation associated with HIV infection. Tools are available to calculate an individual's predicted risk of CVD and should be incorporated in the regular follow-up of HIV-infected patients. Targeted interventions to reduce this risk must be recommended, including life-style changes and medical interventions that might include changes in antiretroviral therapy.

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“…All these mechanisms are incompletely understood and are the focus of active research. Other pathogens, such as cytomegalovirus, might also contribute to this T-cell activation [87].…”

Section: The Role Of Hiv Infection In Itself In the Pathogenesis Of Cmentioning

confidence: 99%

Section: The Role Of Hiv Infection In Itself In the Pathogenesis Of Cmentioning

confidence: 99%

Risk of Cardiovascular Disease in an Aging HIV Population: Where Are We Now?

2015

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“…Some of the direct effects of HIV infection on cardiovascular integrity include microbial translocation1 and the effect of HIV protein Nef on ATP binding cassette transporter A1 (ABCA1),2 the mediator of cholesterol transport 3. Apart from the direct effects of HIV on cardiovascular integrity, some drugs for antiretroviral therapy (ART), mainly reverse transcriptase inhibitors (RTI) and protease inhibitors (PI), have been shown to cause metabolic changes such as dyslipidemia and insulin resistance 4–6.…”

Section: Introductionmentioning

confidence: 99%

Inflammation-modulating cytokine profile and lipid interaction in HIV-related risk factors for cardiovascular diseases

Gori¹,

Mduluza²,

Nyagura³

et al. 2016

TCRM

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HIV infection and antiretroviral therapy (ART) are associated with changes in plasma levels of lipoproteins, thus posing the risk of cardiovascular complications in infected individuals. The alteration in plasma lipoprotein levels results from dysregulation of inflammation-modulating cytokines that control lipid metabolism. Little is understood regarding the relationship between the cytokines and serum lipid levels, which have been reported to be altered in adults receiving ART. The objective of this study was to describe the profiles of inflammation-modulating cytokines and their relationship to lipids as cardiovascular disease (CVD) risk factors in HIV infection. This observational cross-sectional study measured plasma levels of interleukin (IL)-10, tumor necrosis factor-alpha (TNF)-α, IL-4, total cholesterol (TC), and high-density lipoprotein cholesterol (HDL-c) in HIV-infected and uninfected adults. A total of 219 HIV-infected participants were enrolled from an HIV treatment center; of them, 187 were receiving ART and 32 were ART naïve, while 65 were HIV-uninfected blood donors. HIV-infected individuals had higher levels of IL-10 (HIV-infected ART-naïve [P=0.0024] and ART-receiving [P=0.033]) than their uninfected counterparts. ART-naïve subjects had significantly higher plasma levels of IL-10 than ART-receiving subjects (P=0.0014). No significant difference was observed in plasma levels of IL-4 and TNF-α across the three groups. Regarding plasma lipoproteins, HDL-c levels were reduced in HIV ART-naïve (P=0.002) and ART-receiving (P=0.015) subjects compared to HIV-uninfected subjects. Similarly, TC levels were lower in the HIV-infected than in the HIV-uninfected group regardless of whether the patients were undergoing ART or not (P<0.001). IL-10 levels correlated with TC levels in the HIV-uninfected group but not in the HIV-infected groups. Levels of HDL-c were reduced, while IL-10 plasma concentrations were elevated in HIV-infected individuals. A correlation observed in HIV-uninfected individuals between anti-inflammatory cytokine IL-10 and TC was lost in HIV-infected individuals. Clinical significance of these differences needs to be ascertained with respect to HIV-related CVD risk.

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“…It has been reported that plasma RNA viremia [3], cell-associated HIV-DNA level [4] and microbial translocation [5] are potential causes to explain the chronic inflammation and immune activation associated with HIV infection [3,6,7]. In addition, microbial translocation is not only associated with immune activation but also with cardiovascular events [14,15], dyslipidemia [16], lipodystrophy [17] and ultimately would independently determine the rate of disease progression [18] and death [19]. In addition, microbial translocation is not only associated with immune activation but also with cardiovascular events [14,15], dyslipidemia [16], lipodystrophy [17] and ultimately would independently determine the rate of disease progression [18] and death [19].…”

Section: Introductionmentioning

confidence: 99%