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Biomarkers of aging in HIV: inflammation and the microbiome

  • Camilla Tincati
  • Esther Merlini
  • Giuseppe Ancona
  • Giulia Marchetti
Review
  • 13 Downloads

Abstract

Purpose

HIV-infected subjects present increased levels of inflammatory cytokines and T cell activation in the peripheral blood despite suppressive combination antiretroviral therapy which renders them susceptible to premature aging. The purpose of the present work was to review existing evidence on the ways in which the anatomical and microbiological abnormalities of the gastrointestinal tract can represent a major cause of organ disease in HIV infection.

Methods

We conducted a systematic review of the Pubmed database for articles published from 2014 to 2018. We included studies on inflammatory/activation biomarkers associated with cardiovascular and bone disease, neurocognitive impairment and serious non-AIDS events in HIV-infected subjects. We also included researches which linked peripheral inflammation/activation to the anatomical, immune and microbiological alterations of the gastrointestinal tract.

Results

Recent literature data confirm the association between non-infectious comorbidities and inflammation in HIV infection which may be driven by gastrointestinal tract abnormalities, specifically microbial translocation and dysbiosis. Furthermore, there is mounting evidence on the possible role of metabolic functions of the microbiota in the pathogenesis of premature aging in the HIV-infected population.

Conclusions

Biomarkers need to be validated for their use in the management of HIV infection. Compounds which counteract microbial translocation, inflammation and dysbiosis have been investigated as alternative therapeutic strategies in viro-suppressed HIV-infected individuals, but appear to have limited efficacy, probably due to the multifactorial pathogenesis of non-infectious comorbidities in this setting.

Keywords

HIV Inflammation Comorbidities Microbial translocation Microbiome Metabolome 

Notes

Acknowledgements

This work was supported by the Italian Ministry of Health, Regione Lombardia, grant “Giovani Ricercatori” (number GR-2009-1592029; PI: GM) and grant “Ricerca Finalizzata-Progetti di Rete” (number NET-2013-02355333-3; PI: GM).

Compliance with ethical standards

Conflict of interest

On behalf of all authors, the corresponding author states that there is no conflict of interest.

Ethical approval

This article does not contain any studies with human participants or animals performed by any of the authors.

Informed consent

For this type of study, informed consent is not required.

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Copyright information

© European Geriatric Medicine Society 2018

Authors and Affiliations

  1. 1.Department of Health Sciences, Clinic of Infectious Diseases, ASST Santi Paolo e Carlo, San Paolo HospitalUniversity of MilanMilanItaly

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