Human Immunodeficiency Virus-related Microbial Translocation and Progression of Hepatitis C

Overview

Journal Gastroenterology

Specialty Gastroenterology

Date 2008 May 7

PMID 18457674

Citations 156

Authors

Ashwin Balagopal

Frances H Philp

Jacquie Astemborski

Timothy M Block

Anand Mehta

Ronald Long

Gregory D Kirk

Shruti H Mehta

Andrea L Cox

David L Thomas

Stuart C Ray

Affiliations

Soon will be listed here.

Abstract

Background & Aims: Human immunodeficiency virus (HIV)-1 infection has been associated with enhanced microbial translocation, and microbial translocation is a mechanism through which alcohol and some enteric conditions cause liver disease. We hypothesized that HIV promotes liver disease by enhancing microbial translocation.

Methods: We studied human cohorts in which hepatitis C virus (HCV) and HIV outcomes were carefully characterized.

Results: HIV-related CD4(+) lymphocyte depletion was strongly associated with microbial translocation as indicated by elevated levels of circulating lipopolysaccharide (LPS), LPS-binding protein, soluble CD14, and fucose-binding lectin (AAL) reactive to immunoglobulin G specific for the alpha-galactose epitope and suppressed levels of endotoxin core antibodies (EndoCAb IgM) in HIV-infected subjects compared with the same persons before they had HIV infection and compared with HIV-uninfected subjects. The same measures of microbial translocation were strongly associated with HCV-related liver disease progression (cirrhosis), eg, LPS, odds ratio, 19.0 (P = .002); AAL, odds ratio, 27.8 (P < .0001); in addition, levels of LPS were elevated prior to recognition of cirrhosis.

Conclusions: Microbial translocation may be a fundamental mechanism through which HIV accelerates progression of chronic liver disease.

Citing Articles

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HIV, the gut microbiome and clinical outcomes, a systematic review.

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