Association between inflammatory markers and microbial translocation in patients with human immunodeficiency virus infection taking antiretroviral treatment

• Published in: Medicina clinica Vol. 142; no. 2; p. 47
• Main Authors: Reus Bañuls, Sergio, Portilla Sogorb, Joaquín, Sanchez-Paya, José, Boix Martínez, Vicente, Giner Oncina, Livia, Frances, Rubén, Such, José, Merino Lucas, Esperanza, Gimeno Gascón, Adelina
• Format: Journal Article
• Language: Spanish
• Published: Spain 21.01.2014
• Subjects: Adult; Aged; Anti-HIV Agents - therapeutic use; Bacterial Translocation; Biomarkers; Cardiovascular Diseases - epidemiology; Comorbidity; Cross-Sectional Studies; Cytokines - blood; Diabetes Mellitus - epidemiology; DNA, Bacterial - blood; DNA, Ribosomal - blood; Dyslipidemias - epidemiology; Female; Hepatitis C, Chronic - blood; Hepatitis C, Chronic - epidemiology; HIV Infections - blood; HIV Infections - drug therapy; HIV Infections - epidemiology; HIV Infections - microbiology; Humans; Inflammation - blood; Inflammation - epidemiology; Inflammation - microbiology; Male; Middle Aged; RNA, Bacterial - genetics; RNA, Ribosomal, 16S - genetics; Substance Abuse, Intravenous - blood; Substance Abuse, Intravenous - epidemiology; Young Adult; Interleukin 6; Tumour necrosis factor α; Inflamación; Factor de necrosis tumoral α; Traslocación bacteriana; Inflammation; Human immunodeficiency virus; Microbial translocation; Virus de la inmunodeficiencia humana; Interleucina 6
• ISSN: 1578-8989
• DOI: 10.1016/j.medcli.2013.05.044

Inflammatory biomarkers are increased in patients with human immunodeficiency virus (HIV) infection. Antiretroviral treatment (ART) improves some parameters but do not normalize them. The aim of this study is to determine those factors (including microbial translocation) associated with higher inflammation in HIV treated patients. Transversal observational study. HIV patients receiving ART with an HIV viral load (VL)<400 copies/mL. Selection of patients: consecutively between November 2011 and January 2012. Main variable: plasma levels of interleukin 6 (IL-6) and tumour necrosis factor α (TNF-α). Main explanatory variable: microbial translocation markers (16S ribosomal DNA and sCD14). Patients with IL-6 or TNF-α levels above percentile 75 (group 1) were compared with the rest of patients (group 2). Odds ratio (OR) were determined. Eighty-one patients were included (73% male, median age 45 years, 48% stage C). Twenty-six percent had chronic hepatitis C. Median CD4 cell was 493/mm(3) and 30% had detectable HIV VL. 16S ribosomal DNA was detected in 21% of patients. Factors associated with the higher levels of inflammatory markers were 16S ribosomal DNA (OR 77, P<.0001), sCD14 levels (P<.0001) and history of cardiovascular disease (OR 15, P<.01). In multivariate analysis, associations remained for 16S ribosomal DNA (OR 62, P<.0001) and previous cardiovascular disease (OR 25, P<.01). In patients with HIV infection receiving treatment, the higher levels of inflammatory markers are associated with microbial translocation and past cardiovascular events.