title: Elevated plasma levels of lipopolysaccharide and high mobility group box-1 protein are associated with high viral load in HIV-1 infection: reduction by 2-year antiretroviral therapy.
abstract: OBJECTIVE
  To investigate plasma levels of high mobility group box-1 protein (HMGB1), a marker of tissue necrosis and immune activation, as well as lipopolysaccharide (LPS), a marker of bacterial translocation, in HIV-1-infected patients.
  
  
  METHODS
  We studied 32 HIV-1-positive patients who had responded to antiretroviral therapy with undetectable viremia after 2 years, 10 nonresponders and 19 healthy controls.
  
  
  METHODS
  HMGB1 was analyzed by ELISA, and LPS by Lamilus colometric assay. Nonparametric statistics were applied.
  
  
  RESULTS
  In naive HIV-1 patients, HMGB1 and LPS were elevated as compared with controls (P < 0.001). LPS levels were higher in African and Oriental patients compared with whites (P = 0.007). Notably, viral load was two-fold higher in patients with LPS, and HMGB1 was above median as compared with other patients (P = 0.005). This association was largely driven by African patients, who had a five-fold increased viral load in the presence of elevated LPS and HMGB1. After 2 years of effective antiretroviral therapy, LPS was reduced to the same median level as in the control group (P < 0.001), and HMGB1 was also reduced (P = 0.001), whereas no reductions were seen in nonresponders.
  
  
  CONCLUSIONS
  The new findings are the association of elevated plasma levels of LPS and HMGB1 with high viral load, as well as the normalized levels of LPS, and the reduction of HMGB1 after 2 years of effective antiretroviral therapy. As LPS and HMGB1 tend to form immunologically active complexes in vitro, we propose that such complexes may be involved in the immune activation and pathogenesis of HIV-1 infection.
authors.affiliation: Department of Clinical Virology, Karolinska Institutet, Karolinska University Hospital, Huddinge, Stockholm, Sweden. troseid@hotmail.com
authors.forename: Marius
authors.initials: M
authors.lastname: Trøseid
authors.forename: Piotr
authors.initials: P
authors.lastname: Nowak
authors.forename: Jessica
authors.initials: J
authors.lastname: Nyström
authors.forename: Annica
authors.initials: A
authors.lastname: Lindkvist
authors.forename: Samir
authors.initials: S
authors.lastname: Abdurahman
authors.forename: Anders
authors.initials: A
authors.lastname: Sönnerborg
mesh_terms: D000328:Adult; D019380:Anti-HIV Agents / Q000627:therapeutic use*; D015415:Biomarkers / Q000097:blood; D018791:CD4 Lymphocyte Count; D018450:Disease Progression; D005260:Female; D015658:HIV Infections / Q000097:blood* / Q000188:drug therapy / Q000276:immunology / Q000821:virology; D015497:HIV-1 / Q000235:genetics / Q000302:isolation & purification* / Q000502:physiology; D024243:HMGB1 Protein / Q000097:blood*; D006801:Humans; D008070:Lipopolysaccharides / Q000097:blood*; D008297:Male; D012367:RNA, Viral / Q000097:blood; D012189:Retrospective Studies; D019562:Viral Load; D014766:Viremia / Q000097:blood / Q000188:drug therapy / Q000821:virology; D014779:Virus Replication / Q000187:drug effects
chemical_list: D019380:Anti-HIV Agents; D015415:Biomarkers; D024243:HMGB1 Protein; D008070:Lipopolysaccharides; D012367:RNA, Viral