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Title: Protease inhibitor monotherapy is associated with a higher level of monocyte activation, bacterial translocation and inflammation
Author: Torres, Berta
Guardo, Alberto C.
Leal, Lorna
Leon, Agathe
Lucero, Constanza
Álvarez Martínez, Míriam
Martínez Yoldi, Miguel Julián
Vila Estapé, Jordi
Martinez-Rebollar, M.
González-Cordón, Ana
Gatell, José M.
Plana, Montserrat
García Alcaide, Felipe
Keywords: VIH (Virus)
Translocació (Genètica)
Inhibidors enzimàtics
HIV (Viruses)
Antiretroviral agents
Translocation (Genetics)
Enzyme inhibitors
Issue Date: 29-Sep-2014
Publisher: BioMed Central
Abstract: Introduction Monotherapy with protease-inhibitors (MPI) may be an alternative to cART for HIV treatment. We assessed the impact of this strategy on immune activation, bacterial translocation and inflammation. Methods We performed a cross-sectional study comparing patients on successful MPI (n=40) with patients on cART (n=20). Activation, senescence, exhaustion and differentiation stage in CD4+ and CD8+ T lymphocyte subsets, markers of monocyte activation, microbial translocation, inflammation, coagulation and low-level viremia were assessed. Results CD4+ or CD8+ T lymphocyte subset parameters were not significantly different between both groups. Conversely, as compared with triple cART, MPI patients showed a higher proportion of activated monocytes (CD14+ CD16−CD163+ cells, p=0.031), soluble markers of monocyte activation (sCD14 p=0.004, sCD163 p=0.002), microbial translocation (lipopolysaccharide (LPS)-binding protein; LBP p=0.07), inflammation (IL-6 p=0.04) and low-level viremia (p=0.035). In a multivariate model, a higher level of CD14+ CD16−CD163+ cells and sCD14, and presence of very low-level viremia were independently associated with MPI. Monocyte activation was independently associated with markers of inflammation (IL-6, p=0.006), microbial translocation (LBP, p=0.01) and low-level viremia (p=0.01). Conclusions Patients on MPI showed a higher level of monocyte activation than patients on standard therapy. Microbial translocation and low-level viremia were associated with the high level of monocyte activation observed in patients on MPI. The long-term clinical consequences of these findings should be assessed.
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It is part of: Journal of the International AIDS Society, 2014, vol. 17, num. 1, p. 19246
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ISSN: 1758-2652
Appears in Collections:Articles publicats en revistes (Fonaments Clínics)
Articles publicats en revistes (IDIBAPS: Institut d'investigacions Biomèdiques August Pi i Sunyer)
Articles publicats en revistes (Medicina)

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