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Long-term suppressive combined antiretroviral treatment does not normalize the serum level of soluble CD14

Gema Méndez-Lagares1, M Concepción Romero-Sánchez, Ezequiel Ruiz-Mateos

  • 1Laboratory of Immunovirology, Clinic Unit of Infectious Diseases, Microbiology and Preventive Medicine, Institute of Biomedicine of Seville, IBiS, Virgen del Rocío University Hospital/CSIC/University of Seville, Spain.

The Journal of Infectious Diseases
|January 17, 2013
PubMed

Insights

Soluble CD14 (sCD14) levels remain elevated in human immunodeficiency virus (HIV)-infected individuals even with long-term combined antiretroviral therapy (cART). Early cART initiation is beneficial, but complementary therapies may be needed for chronic HIV-associated inflammation.

Area of Science:

  • Immunology
  • Virology
  • Infectious Diseases

Background:

  • Chronic human immunodeficiency virus (HIV) infection is associated with persistent immune activation and inflammation.
  • Soluble CD14 (sCD14), a marker of monocyte/macrophage activation, is often elevated in HIV infection.
  • The impact of long-term combined antiretroviral therapy (cART) on sCD14 levels requires further investigation.

Purpose of the Study:

  • To longitudinally assess soluble CD14 (sCD14) levels in HIV-infected individuals receiving suppressive cART.
  • To compare sCD14 levels between HIV-infected subjects on cART and HIV-negative control groups.
  • To explore the relationship between baseline CD4(+) T-cell counts and sCD14 levels in HIV infection.

Main Methods:

  • Longitudinal measurement of sCD14 levels in 85 HIV-infected subjects during long-term cART.
  • Comparison of sCD14 levels with young and elderly HIV-negative control subjects.
  • Statistical analysis to determine associations between sCD14, cART, and CD4(+) T-cell counts.

Main Results:

  • Combined antiretroviral therapy (cART) did not normalize sCD14 levels in HIV-infected individuals.
  • HIV-infected subjects exhibited significantly higher sCD14 levels at baseline, 1 year, and 5 years after cART initiation compared to controls.
  • Baseline CD4(+) T-cell count was inversely associated with baseline sCD14 levels.

Conclusions:

  • Elevated sCD14 levels persist despite suppressive cART, indicating ongoing immune activation in chronic HIV infection.
  • Early initiation of cART is beneficial for managing HIV infection.
  • Complementary therapies may be necessary to address the activated/inflamed status associated with chronic HIV infection.

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