Increased Microbial Translocation is a Prognostic Biomarker of Different Immune Responses to ART in People Living with HIV

Abstract

Background

Microbial translocation (MT) is a characteristic of human immunodeficiency virus (HIV) infection. Whether MT is also a biomarker of different immune responses to antiretroviral therapy (ART) received by people living with HIV (PLWH) is not known.

Methods

We examined the presence of MT in a cohort of 33 HIV-infected immunological responders (IRs) and 28 immunological non-responders (INRs) (≥500 and <200 cluster of differentiation (CD)4+ T-cell counts/µL after 2 years of HIV-1 suppression, respectively) with no comorbidities. Plasma samples were used to measure the circulating levels of MT markers. All enrolled study participants had received 2 years of viral-suppression therapy.

Results

Levels of lipopolysaccharide (P = 0.0185), LPS-binding protein (P < 0.0001), soluble-CD14 (P < 0.0001), and endogenous endotoxin-core antibody (P < 0.0001) at baseline were significantly higher in INRs than in IRs and were associated with an increased risk of an immunological non-response, whereas the level of intestinal fatty acid-binding protein did not show this association. Analysis of receiver operating characteristic (ROC) curves demonstrated the utility of these individual microbial markers in discriminating INRs after ART in people living with HIV with high sensitivity, specificity, and area under the ROC curve.

Conclusion

INRs in HIV infection are characterized by increased MT at baseline. These markers could be used as a rapid prognostic tool for predicting immune responses in people infected with the HIV.

Keywords:

• HIV
• immunological non-responders
• microbial translocation

Data Sharing Statement

All the reported data are available within the article.

Ethics Statement

This study was performed in line with the principles of the Declaration of Helsinki. This study was approved by the Institutional Review Committee of the First Affiliated Hospital of Zhejiang University (ethical number 2020-IIT54). Written informed consent was obtained from all participants. All the methods were performed in accordance with the relevant institutional ethical committee guidelines.

Acknowledgments

The authors acknowledge all the participants for their involvement in the study.

Disclosure

The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest.

Additional information

Funding

This work was supported by the Research Project of Jinan Microecological Biomedicine Shandong Laboratory (grant numbers JNL-20220038C, JNL-2022005B).