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Pattern of microbial translocation in patients living with HIV-1 from Vietnam, Ethiopia and Sweden

Samir Abdurahman, Babilonia Barqasho, Piotr Nowak, Do Duy Cuong, Wondwossen Amogne, Mattias Larsson, Lars Lindquist, Gaetano Marrone, Anders Sönnerborg

Abstract


Introduction: The role of microbial translocation (MT) in HIV patients living with HIV from low- and middle-income countries (LMICs) is not fully known. The aim of this study is to investigate and compare the patterns of MT in patients from Vietnam, Ethiopia and Sweden.

Methods: Cross-sectional samples were obtained from treatment-naïve patients living with HIV-1 and healthy controls from Vietnam (n=83; n=46), Ethiopia (n=9492; n=50) and Sweden (n=51; n=19). Longitudinal samples were obtained from a subset of the Vietnamese (n=24) in whom antiretroviral therapy (ART) and tuberculostatics were given. Plasma lipopolysaccharide (LPS), sCD14 and anti-flagellin IgG were determined by the endpoint chromogenic Limulus Amebocyte Assay and enzyme-linked immunosorbent assay.

Results: All three biomarkers were significantly increased in patients living with HIV-1 from all countries as compared to controls. No differences were found between males and females. Vietnamese and Ethiopian patients had significantly higher levels of anti-flagellin IgG and LPS, as compared to Swedes. ART reduced these levels for the Vietnamese. Vietnamese patients given tuberculostatics at initiation of ART had significantly lower levels of anti-flagellin IgG and higher sCD14. The biomarkers were lower in Vietnamese who did not develop opportunistic infection.

Conclusions: Higher MT is common in patients living with HIV compared to healthy individuals, and in patients from LMICs compared to patients from a high-income country. Treatment with tuberculostatics decreased MT while higher levels of MT are associated with a poorer clinical outcome.

Keywords: microbial translocation; immune activation; LPS; sCD14; treatment-naïve patients living with HIV; HIV in Vietnam; HIV in Ethiopia; HIV in Sweden.

(Published: 24 January 2014)

Citation: Abdurahman S et al. Journal of the International AIDS Society 2014, 17:18841

http://www.jiasociety.org/index.php/jias/article/view/18841 | http://dx.doi.org/10.7448/IAS.17.1.18841




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