Back HIV Basic Science Inflammation

Inflammation & Immune Activation

Immune Activation and Inflammation Due to Leaking Gut Bacteria Linked to HIV Disease Progression

Microbial translocation, or leakage of bacteria from the gut, is increased in people with HIV and is associated with ongoing immune activation, CD4 cell loss, higher viral load, and progression to AIDS, according to 3 recently published reports. One study found that effective antiretroviral therapy (ART) reduced levels of the bacterial toxin lipopolysaccharide (LPS) to normal levels in HIV positive adults, but a study of HIV-infected children showed that LPS elevation and immune activation persisted even after CD4 cell recovery and viral suppression on ART.

Read more:

CROI 2010: ART Intensification with Maraviroc (Selzentry) or Raltegravir (Isentress) May Improve Immune Activation and Inflammation

The CCR5 antagonist maraviroc (Selzentry) was associated with reduced immune activation and inflammation in 3 studies presented at the 17th Conference on Retroviruses and Opportunistic Infections (CROI 2010) last month in San Francisco. The integrase inhibitor raltegravir (Isentress) may also have some inflammation-dampening effect, but 3 recent studies produced mixed results.

Read more:

Inflammatory Markers and Cardiovascular Risk in Treated and Untreated People with HIV

Two recently published studies shed further light on the relationship between inflammation and non-AIDS conditions in people with HIV. One study found that HIV positive people may have elevated levels of the inflammatory biomarker high-sensitivity C-reactive protein (CRP), even if they are on effective antiretroviral therapy (ART) and otherwise have a low cardiovascular risk. The second study found that people with untreated HIV infection had lower HDL (good) cholesterol and increased levels of inflammatory and coagulation markers compared with HIV negative individuals.

Read more:

CROI 2010: Inflammation and Immune Activation Linked to Increase Mortality Risk in People with HIV

Inflammation and excessive CD8 T-cell immune activation were independent predictors of increased risk of death both in a U.S. study and among HIV patients starting antiretroviral therapy (ART) in Uganda, according to 2 reports presented at the 17th Conference on Retroviruses and Opportunistic Infections (CROI 2010) last month in San Francisco. While lower CD4 cell count may explain part of the association, inflammation itself was an independent predictor of mortality.

Read more:

Body Composition and Metabolic Changes in the SMART Treatment Interruption Trial

Intermittent antiretroviral therapy (ART) was associated with increased subcutaneous fat, but no changes in visceral abdominal fat, according to an analysis from the large SMART treatment interruption trial published in the January 2010 issue of AIDS. In addition, levels of both LDL (bad) and HDL (good) cholesterol decreased, while one measure of blood glucose increased.

Read more: