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Kinetics of microbial translocation markers in patients on efavirenz or lopinavir/r based antiretroviral therapy
Unit of Infectious Diseases, Department of Medicine, Karolinska Institutet, Karolinska University Hospital, Huddinge, Stockholm, Sweden .
Unit of Infectious Diseases, Department of Medicine, Karolinska Institutet, Karolinska University Hospital, Huddinge, Stockholm, Sweden; Department of Laboratory Medicine, Division of Clinical Microbiology, Karolinska Institutet, Karolinska University Hospital, Huddinge, Stockholm, Sweden.
Department of Laboratory Medicine, Division of Clinical Microbiology, Karolinska Institutet, Karolinska University Hospital, Huddinge, Stockholm, Sweden.
Unit of Infectious Diseases, Department of Medicine, Karolinska Institutet, Karolinska University Hospital, Huddinge, Stockholm, Sweden .ORCID iD: 0000-0003-0902-508X
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2013 (English)In: PloS one, ISSN 1932-6203, Vol. 8, no 1, e55038- p.Article in journal (Refereed) Published
Abstract [en]

OBJECTIVES: We investigated whether there are differences in the effects on microbial translocation (MT) and enterocyte damage by different antiretroviral therapy (ART) regimens after 1.5 years and whether antibiotic use has impact on MT. In a randomized clinical trial (NCT01445223) on first line ART, patients started either lopinavir/r (LPV/r) (n = 34) or efavirenz (EFV) containing ART (n = 37). Lipopolysaccharide (LPS), sCD14, anti-flagellin antibodies and intestinal fatty acid binding protein (I-FABP) levels were determined in plasma at baseline (BL) and week 72 (w72).

RESULTS: The levels of LPS and sCD14 were reduced from BL to w72 (157.5 pg/ml vs. 140.0 pg/ml, p = 0.0003; 3.13 ug/ml vs. 2.85 ug/ml, p = 0.005, respectively). The levels of anti-flagellin antibodies had decreased at w72 (0.35 vs 0.31 [OD]; p<0.0004), although significantly only in the LPV/r arm. I-FABP levels increased at w72 (2.26 ng/ml vs 3.13 ng/ml; p<0.0001), although significantly in EFV treated patients only. Patients given antibiotics at BL had lower sCD14 levels at w72 as revealed by ANCOVA compared to those who did not receive (Δ = -0.47 µg/ml; p = 0.015).

CONCLUSIONS: Markers of MT and enterocyte damage are elevated in untreated HIV-1 infected patients. Long-term ART reduces the levels, except for I-FABP which role as a marker of MT is questionable in ART-experienced patients. Why the enterocyte damage seems to persist remains to be established. Also antibiotic usage may influence the kinetics of the markers of MT.

TRIAL REGISTRATION: ClinicalTrials.gov NCT01445223.

Place, publisher, year, edition, pages
2013. Vol. 8, no 1, e55038- p.
National Category
Clinical Medicine
Research subject
Medicine
Identifiers
URN: urn:nbn:se:oru:diva-41997DOI: 10.1371/journal.pone.0055038ISI: 000315211500050PubMedID: 23383047Scopus ID: 2-s2.0-84873813972OAI: oai:DiVA.org:oru-41997DiVA: diva2:792882
Funder
Swedish Research Council
Note

Funding Agencies:

Stockholm County Council

Swedish Physicians against AIDS

Swedish Medical Society (SLS)

Swedish Society for Medical Research (SSMF for Piotr Nowak)

Sahlgrenska Academy at University of Gothenburg

Health & Medical Care Committee of the Region Vastra Gotaland

Available from: 2015-03-05 Created: 2015-01-16 Last updated: 2017-10-17Bibliographically approved

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