Biomarkers of aging in HIV: inflammation and the microbiome
- 13 Downloads
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.
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.
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.
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.
KeywordsHIV Inflammation Comorbidities Microbial translocation Microbiome Metabolome
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.
This article does not contain any studies with human participants or animals performed by any of the authors.
For this type of study, informed consent is not required.
- 33.Hsu DC, Sunyakumthorn P, Wegner M, et al (2018) Central nervous system inflammation and infection during early, nonaccelerated simian-human immunodeficiency virus infection in Rhesus Macaques. J Virol 92Google Scholar
- 36.Montoya JL, Campbell LM, Paolillo EW, et al (2018) Inflammation relates to poorer complex motor performance among adults living with HIV on suppressive antiretroviral therapy. J Acquir Immune Defic SyndrGoogle Scholar
- 45.McComsey GA, Kitch D, Sax PE et al (2014) Associations of inflammatory markers with AIDS and non-AIDS clinical events after initiation of antiretroviral therapy: AIDS clinical trials group A5224s, a substudy of ACTG A5202. J Acquir Immune Defic Syndr 65:167–174CrossRefPubMedPubMedCentralGoogle Scholar
- 77.Haissman JM, Haugaard AK, Ostrowski SR et al (2017) Microbiota-dependent metabolite and cardiovascular disease marker trimethylamine-N-oxide (TMAO) is associated with monocyte activation but not platelet function in untreated HIV infection. BMC Infect Dis 17:445CrossRefPubMedPubMedCentralGoogle Scholar
- 80.Alakkas A, Ellis RJ, Watson CW et al (2018) White matter damage, neuroinflammation, and neuronal integrity in HAND. J NeurovirolGoogle Scholar
- 82.Serrano-Villar S, de Lagarde M, Vázquez-Castellanos J et al (2018) Effects of immunonutrition in advanced HIV disease: a randomized placebo controlled clinical trial (Promaltia study). Clin Infect DisGoogle Scholar