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Sequencing of Bacterial Microflora in Peripheral Blood: our Experience with HIV-infected Patients
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Sequencing of Bacterial Microflora in Peripheral Blood: our Experience with HIV-infected Patients

Published on: June 11, 2011

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Human immunodeficiency virus-related microbial translocation and progression of hepatitis C

Ashwin Balagopal1, Frances H Philp, Jacquie Astemborski

  • 1Division of Infectious Diseases, Viral Hepatitis Center, Department of Medicine, The Johns Hopkins Medical Institutions, Baltimore, Maryland, USA.

Gastroenterology
|May 7, 2008
PubMed
Abstract

Insights

Human immunodeficiency virus (HIV) infection enhances microbial translocation, a key factor in liver disease progression. This study links HIV-related immune changes to increased microbial translocation, accelerating liver damage, particularly in hepatitis C virus (HCV) coinfection.

Area of Science:

  • Immunology
  • Hepatology
  • Infectious Diseases

Background:

  • Human immunodeficiency virus (HIV)-1 infection is linked to increased microbial translocation.
  • Microbial translocation is a known mechanism contributing to alcohol- and enteric-related liver disease.
  • HIV may promote liver disease by enhancing microbial translocation.

Purpose of the Study:

  • To investigate the hypothesis that HIV infection promotes liver disease by enhancing microbial translocation.
  • To assess the association between HIV infection, immune status, and markers of microbial translocation.
  • To evaluate the role of microbial translocation in the progression of liver disease, particularly in the context of hepatitis C virus (HCV) coinfection.

Main Methods:

  • Study of human cohorts with characterized hepatitis C virus (HCV) and HIV outcomes.
  • Measurement of microbial translocation markers including lipopolysaccharide (LPS), LPS-binding protein, soluble CD14, and fucose-binding lectin (AAL).
  • Assessment of endotoxin core antibodies (EndoCAb IgM) and correlation with HIV status, CD4(+) lymphocyte counts, and liver disease progression.

Main Results:

  • HIV-related CD4(+) lymphocyte depletion strongly correlated with microbial translocation markers (elevated LPS, LPS-binding protein, soluble CD14, AAL; suppressed EndoCAb IgM).
  • These microbial translocation markers were significantly associated with HCV-related liver disease progression to cirrhosis.
  • Elevated LPS levels were observed prior to the clinical recognition of cirrhosis, suggesting early involvement.

Conclusions:

  • Microbial translocation is a potential fundamental mechanism driving accelerated chronic liver disease progression in HIV-infected individuals.
  • HIV-associated immune dysregulation contributes to increased microbial translocation.
  • Targeting microbial translocation may be a therapeutic strategy to mitigate liver disease progression in HIV patients.

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