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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
León García, Agathe
Lucero, Constanza
Álvarez Martínez, Míriam
Martínez Yoldi, Miguel Julián
Vila Estapé, Jordi
Martínez Rebollar, María
González Cordón, Ana
Gatell, José M.
Plana Prades, 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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