Intestinal barrier dysfunction in HIV infection: pathophysiology, clinical implications and potential therapies

Area of Science:

• Immunology
• Gastroenterology
• Virology

Background:

• HIV infection is characterized by chronic immune activation, leading to T lymphocyte imbalance and disease progression.
• Pathological microbial translocation (MT) is a primary driver of this sustained immune activation in HIV patients.

Purpose of the Study:

• To review the literature on intestinal barrier dysfunction in HIV infection.
• To emphasize the pathophysiological mechanisms, clinical implications, and therapeutic interventions for intestinal barrier defects in HIV.

Main Methods:

• Literature review focusing on intestinal barrier integrity in HIV infection.
• Analysis of mechanisms, clinical impact, and treatment strategies for microbial translocation.

Main Results:

• HIV infection impairs the intestinal barrier's biological, immune, and mechanical components.
• This dysfunction facilitates microbial translocation, promoting local and systemic inflammation, contributing to disease progression, and affecting treatment response.

Conclusions:

• Effective HIV management requires combining viral load control with strategies to restore intestinal barrier function.
• Targeting microbial translocation may improve immune homeostasis and reduce morbidity and mortality in HIV-infected individuals.