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Fungal Translocation Is Associated with Immune Activation and Systemic Inflammation in Treated HIV
Journal article   Open access   Peer reviewed

Fungal Translocation Is Associated with Immune Activation and Systemic Inflammation in Treated HIV

Lukasz D Weiner, Mauricio Retuerto, Christopher L Hager, Vanessa El Kamari, Lingpeng Shan, Abdus Sattar, Manjusha Kulkarni, Nicholas Funderburg, Mahmoud A Ghannoum, Sahera Dirajlal-Fargo, …
AIDS research and human retroviruses, Vol.35(5), pp.461-472
05/2019
DOI: 10.1089/AID.2018.0252
PMCID: PMC6516070
PMID: 30784316
url
https://doi.org/10.1089/AID.2018.0252View
Published (Version of record) Open Access

Abstract

The mechanisms causing HIV-associated immune activation remain incompletely understood. Alteration of intestinal integrity with subsequent translocation of bacterial products appears to play an important role; however, little is known about the impact of fungal translocation. We assessed the effect of fungal translocation and its association with immune activation in people living with HIV (PLWH) compared with uninfected controls. We measured serum levels of β-D-glucan (BDG) and anti- antibodies (ASCA) immunoglobulin G (IgG) and immunoglobulin A (IgA) and markers of systemic inflammation and immune activation in virally suppressed PLWH on antiretroviral therapy (ART) and uninfected controls. T-test and Mann-Whitney tests were used to compare markers by HIV status and correlation and regression analyses were used to assess associations of fungal translocation markers with markers of inflammation. One hundred seventy-six participants were included (128 HIV+ and 48 HIV-); 72% male, 65% African American, median age was 50 years, and CD4 was 710 cells/cm . Levels of BDG tended to be lower in HIV+ when compared with controls (  = .05). No significant difference in levels of ASCA IgG and IgA was seen between groups (  > .75). There was a significant correlation between BDG and several markers of inflammation and immune activation in PLWH, not seen in uninfected controls. In contrast, no correlations were seen between levels of ASCA IgG and IgA with inflammatory markers. PLWH on ART do not have higher levels of BDG or ASCA when compared with uninfected controls, however, the association found between BDG and several inflammation markers suggests a potential role of fungal translocation in the heightened immune activation seen in treated HIV.
HIV Infections - blood Saccharomyces cerevisiae - immunology Cross-Sectional Studies Immunoglobulin G - blood Antiviral Agents - therapeutic use Lymphocyte Activation Humans Middle Aged Antibodies, Fungal - blood Male Inflammation Biomarkers - blood HIV Infections - immunology HIV Infections - microbiology Immunoglobulin A - blood Adult Female HIV Infections - drug therapy Cohort Studies Glucans - blood

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