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Chronic, Acute, and Reactivated HIV Infection in Humanized Immunodeficient Mouse Models
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Brief Report: Gut Structural Damage: an Ongoing Process in Chronically Untreated HIV Infection
Vanessa El Kamari1,2, Abdus Sattar1, Grace A Mccomsey1,2
1Case Western Reserve University, Cleveland, OH.
Journal of Acquired Immune Deficiency Syndromes (1999)
|November 14, 2018
Summary
Gut structural damage progresses in untreated HIV infection, with intestinal fatty acid-binding proteins (I-FABP) increasing over time. This damage correlates with viral replication and inflammation, highlighting I-FABP as a key biomarker.
Area of Science:
- Immunology
- Virology
- Gastroenterology
Background:
- Chronic untreated Human Immunodeficiency Virus (HIV) infection can lead to progressive gut structural damage.
- Intestinal barrier dysfunction is a recognized complication in HIV, impacting disease progression and immune status.
Purpose of the Study:
- To investigate longitudinal changes in gut structural damage markers in HIV-infected individuals.
- To assess the association between gut structural damage, HIV viral load, CD4 T-cell counts, and inflammation markers over 96 weeks.
Main Methods:
- A 96-week prospective cohort study involving antiretroviral therapy-naive HIV-infected participants.
- Intestinal fatty acid-binding proteins (I-FABP) measured as a surrogate for gut structural damage.
- Statistical analyses included Spearman correlations and linear mixed-effect models.
Main Results:
- I-FABP levels significantly increased from baseline to week 96 (P = 0.03), indicating worsening gut damage.
- Increased I-FABP was associated with higher HIV viral replication (P = 0.03) and inflammatory markers (sTNFR-II, sVCAM-1).
- Lower baseline CD4 T-cell counts were independently associated with I-FABP progression (P = 0.02).
Conclusions:
- Gut structural damage is an active process in chronic untreated HIV infection, driven by viral replication.
- I-FABP serves as a valuable biomarker for intestinal barrier dysfunction, correlating with immune status and inflammation.
- These findings underscore the importance of managing HIV to prevent ongoing gastrointestinal complications.
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