Journal article
Altered Intestinal Permeability and Fungal Translocation in Ugandan Children With Human Immunodeficiency Virus
Clinical infectious diseases, Vol.70(11), pp.2413-2422
05/23/2020
DOI: 10.1093/cid/ciz561
PMCID: PMC7245151
PMID: 31260509
Abstract
Children with perinatally acquired human immunodeficiency virus (HIV; PHIVs) face a lifelong cumulative exposure to HIV and antiretroviral therapy (ART). The relationship between gut integrity, microbial translocation, and inflammation in PHIV is poorly understood.
This is a cross-sectional study in 57 PHIVs, 59 HIV-exposed but uninfected children, and 56 HIV-unexposed and -uninfected children aged 2-10 years old in Uganda. PHIVs were on stable ART with HIV-1 RNA <400 copies/mL. We measured markers of systemic inflammation, monocyte activation, and gut integrity. Kruskal-Wallis tests were used to compare markers by group and the Spearman correlation was used to assess correlations between biomarkers.
The mean age of all participants was 7 years and 55% were girls. Among PHIVs, the mean CD4 % was 34%, 93% had a viral load ≤20 copies/mL, and 79% were on a nonnucleoside reverse transcriptase inhibitor regimen. Soluble cluster of differentiation 14 (sCD14), beta-D-glucan (BDG), and zonulin were higher in the PHIV group (P ≤ .01). Intestinal fatty acid binding protein (I-FABP) and lipopolysaccharide binding protein (LBP) did not differ between groups (P > .05). Among PHIVs who were breastfed, levels of sCD163 and interleukin 6 (IL6) were higher than levels in PHIV who were not breastfed (P < .05). Additionally, in PHIVs with a history of breastfeeding, sCD14, BDG, LBP, zonulin, and I-FABP correlated with several markers of systemic inflammation, including high-sensitivity C-reactive protein, IL6, d-dimer, and systemic tumor necrosis factor receptors I and II (P ≤ .05).
Despite viral suppression, PHIVs have evidence of altered gut permeability and fungal translocation. Intestinal damage and the resultant bacterial and fungal translocations in PHIVs may play a role in the persistent inflammation that leads to many end-organ diseases in adults.Despite viral suppression, children with perinatally acquired human immunodeficiency virus (HIV) in Uganda have evidence of alterations in intestinal permeability and fungal translocation, compared to HIV-exposed but uninfected and HIV-unexposed children, which may play a role in HIV-associated chronic inflammation.
Details
- Title: Subtitle
- Altered Intestinal Permeability and Fungal Translocation in Ugandan Children With Human Immunodeficiency Virus
- Creators
- Sahera Dirajlal-Fargo - Case Western Reserve University, ColumbusVanessa El-Kamari - Case Western Reserve University, ColumbusLukasz Weiner - Rainbow Babies and Children's Hospital, ColumbusLingpeng Shan - Case Western Reserve University, ColumbusAbdus Sattar - Case Western Reserve University, ColumbusManjusha Kulkarni - Ohio State University School of Health and Rehabilitation Sciences, ColumbusNicholas Funderburg - Ohio State University School of Health and Rehabilitation Sciences, ColumbusRashidah Nazzinda - Joint Clinical Research Centre, Kampala, UgandaChristine Karungi - Joint Clinical Research Centre, Kampala, UgandaCissy Kityo - Joint Clinical Research Centre, Kampala, UgandaVictor Musiime - Department of Paediatrics and Child Health, Makerere University, Kampala, UgandaGrace A McComsey - Case Western Reserve University, Columbus
- Resource Type
- Journal article
- Publication Details
- Clinical infectious diseases, Vol.70(11), pp.2413-2422
- DOI
- 10.1093/cid/ciz561
- PMID
- 31260509
- PMCID
- PMC7245151
- ISSN
- 1058-4838
- eISSN
- 1537-6591
- Grant note
- K23 HD088295 / NICHD NIH HHS R21 DK118757 / NIDDK NIH HHS
- Language
- English
- Date published
- 05/23/2020
- Academic Unit
- Stead Family Department of Pediatrics; Infectious Disease (Pediatrics)
- Record Identifier
- 9984093496902771
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