Inflammation burden score in multidrug-resistant HIV-1 infection - 27/04/23
, Roberta Caccia b , Laura Galli b , Andrea Galli b , Andrea Poli b , Giulia Carla Marchetti c , Alessandra Bandera d , Maurizio Zazzi e , Maria Mercedes Santoro f , Paola Cinque b , Antonella Castagna a, b , Vincenzo Spagnuolo b on behalf of the PRESTIGIO Study Group
Summary |
Objectives |
Four-class drug-resistant (4DR) people living with HIV (PLWH) are a fragile population with a high burden of disease. No data on their inflammation and T-cell exhaustion markers are currently available.
Methods |
Inflammation, immune activation and microbial translocation biomarkers were measured through ELISA in 30 4DR-PLWH with HIV-1 RNA ≥ 50 copies/mL, 30 non-viremic 4DR-PLWH and 20 non-viremic non-4DR-PLWH. Groups were matched by age, gender and smoking habit. T-cell activation and exhaustion markers were assessed by flow cytometry in 4DR-PLWH. An inflammation burden score (IBS) was calculated from soluble marker levels and associated factors were estimated through multivariate regression.
Results |
The highest plasma biomarker concentrations were observed in viremic 4DR-PLWH, the lowest ones in non-4DR-PLWH. Endotoxin core immunoglobulin G showed an opposite trend. Among 4DR-PLWH, CD38/HLA-DR and PD-1 were more expressed on CD4+ (p = 0.019 and 0.034, respectively) and CD8+ (p = 0.002 and 0.032, respectively) cells of viremic compared to non-viremic subjects. An increased IBS was significantly associated with 4DR condition, higher values of viral load and a previous cancer diagnosis.
Conclusions |
Multidrug-resistant HIV infection is associated with a higher IBS, even when viremia is undetectable. Therapeutic approaches aimed to reduce inflammation and T-cell exhaustion in 4DR-PLWH need to be investigated.
Le texte complet de cet article est disponible en PDF.Highlights |
• | Matched-cohort study on four-class drug-resistant (4DR) and non-4DR-PLWH. |
• | Inflammation burden score (IBS) was calculated from plasma levels of 9 biomarkers. |
• | IBS was higher in 4DR-PLWH, even when non-viremic, than in non-4DR-PLWH. |
• | T cells were more ‘exhausted’ in viremic than non-viremic 4DR-PLWH. |
• | Further studies on treatments targeting these pathways in 4DR-PLWH are required. |
Abbreviations : AIDS, ART, BDG, CRP, CTLA4, DMEM, EndoCAb, FBS, HAVCR2 or Tim-3, HBsAg, HCV, HIV, HLA, hs, IBS, IL, INSTI, IQR, MACE, MDR, NRTI, NNRTI, PBMC, PDCD1 or PD-1, PI, PLWH, PYFU, s, TNF, 4DR, 95%CI
Keywords : HIV, Drug resistance, Inflammation, Immune activation, Bacterial translocation, Immunosenescence
Plan
Vol 86 - N° 5
P. 453-461 - mai 2023 Retour au numéro
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