Relationship between microbial translocation and endothelial function in HIV infected patients

Area of Science:

• Cardiovascular Health
• Infectious Diseases
• Immunology

Background:

• Elevated microbial products in HIV infection can cause endothelial dysfunction.
• Understanding the link between microbial translocation and cardiovascular disease in HIV is crucial.

Purpose of the Study:

• To investigate the association between microbial products (lipopolysaccharide and soluble CD14) and endothelial function (flow-mediated dilation) in HIV-infected individuals.
• To determine if these associations differ between untreated individuals, those recently initiating ART, and those on long-term ART.

Main Methods:

• Cross-sectional and prospective cohort studies were analyzed.
• Brachial artery flow-mediated dilation (FMD) was measured using ultrasound.
• Plasma lipopolysaccharide (LPS) and soluble CD14 (sCD14) levels were quantified and correlated with FMD.

Main Results:

• Neither LPS nor sCD14 levels correlated significantly with FMD in the overall cohorts.
• In HIV-infected individuals on long-term ART (mean duration 40 months), higher LPS levels were inversely correlated with FMD (r=-0.33, p=0.02).
• LPS remained an independent predictor of FMD in this subgroup (p=0.02), while sCD14 did not.

Conclusions:

• Higher LPS levels are associated with poorer endothelial function in HIV-infected individuals on long-term ART.
• This association was not observed in untreated subjects or those recently starting ART.
• Persistent microbial translocation may contribute to arterial dysfunction and increased cardiovascular disease risk in individuals on long-term ART.