Kinetics of Microbial Translocation Markers in Patients on Efavirenz or Lopinavir/r Based Antiretroviral Therapy
Artikel i vetenskaplig tidskrift, 2013

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 (Delta = -0.47 mu g/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.

Författare

J. Vesterbacka

Karolinska universitetssjukhuset

P. Nowak

Karolinska universitetssjukhuset

B. Barqasho

Karolinska universitetssjukhuset

S. Abdurahman

Karolinska universitetssjukhuset

J. Nystrom

Karolinska universitetssjukhuset

Staffan Nilsson

Göteborgs universitet

Chalmers, Matematiska vetenskaper, matematisk statistik

H. Funaoka

DS Pharma Biomedical Co., Ltd.

T. Kanda

Niigata University School of Medicine

L. M. Andersson

Göteborgs universitet

M. Gisslen

Göteborgs universitet

A. Sonnerborg

Karolinska universitetssjukhuset

PLoS ONE

1932-6203 (ISSN)

Vol. 8 1 artikel nr e55038- e55038

Ämneskategorier

Klinisk medicin

DOI

10.1371/journal.pone.0055038