title: Kinetics of microbial translocation markers in patients on efavirenz or lopinavir/r based antiretroviral therapy.
abstract: OBJECTIVE
  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 (Δ = -0.47 µg/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.
  
  
  BACKGROUND
  ClinicalTrials.gov NCT01445223.
authors: Unit of Infectious Diseases, Department of Medicine, Karolinska Institutet, Karolinska University Hospital, Huddinge, Stockholm, Sweden. jan.vesterbacka@karolinska.se
authors: Jan
authors: J
authors: Vesterbacka
authors: Piotr
authors: P
authors: Nowak
authors: Babilonia
authors: B
authors: Barqasho
authors: Samir
authors: S
authors: Abdurahman
authors: Jessica
authors: J
authors: Nyström
authors: Staffan
authors: S
authors: Nilsson
authors: Hiroyuki
authors: H
authors: Funaoka
authors: Tatsuo
authors: T
authors: Kanda
authors: Lars-Magnus
authors: LM
authors: Andersson
authors: Magnus
authors: M
authors: Gisslèn
authors: Anders
authors: A
authors: Sönnerborg
mesh_terms: D000328:Adult; D000368:Aged; D000480:Alkynes; D000900:Anti-Bacterial Agents / Q000494:pharmacology; D019380:Anti-HIV Agents / Q000494:pharmacology / Q000627:therapeutic use*; D000907:Antibodies, Bacterial / Q000276:immunology / Q000378:metabolism; D001419:Bacteria / Q000187:drug effects* / Q000276:immunology / Q000378:metabolism; D048588:Benzoxazines / Q000494:pharmacology / Q000627:therapeutic use*; D015415:Biomarkers / Q000378:metabolism; D015496:CD4-Positive T-Lymphocytes / Q000187:drug effects / Q000276:immunology; D003521:Cyclopropanes; D004338:Drug Combinations; D050556:Fatty Acid-Binding Proteins / Q000378:metabolism; D005260:Female; D005408:Flagellin / Q000276:immunology; D015497:HIV-1 / Q000187:drug effects / Q000502:physiology; D006801:Humans; D007700:Kinetics; D018950:Lipopolysaccharide Receptors / Q000737:chemistry / Q000378:metabolism; D008070:Lipopolysaccharides / Q000378:metabolism; D061466:Lopinavir / Q000494:pharmacology / Q000627:therapeutic use*; D008297:Male; D008875:Middle Aged; D009068:Movement / Q000187:drug effects*; D012995:Solubility; D013997:Time Factors; D019562:Viral Load / Q000187:drug effects; D055815:Young Adult
chemical_list: D000480:Alkynes; D000900:Anti-Bacterial Agents; D019380:Anti-HIV Agents; D000907:Antibodies, Bacterial; D048588:Benzoxazines; D015415:Biomarkers; D003521:Cyclopropanes; D004338:Drug Combinations; D050556:Fatty Acid-Binding Proteins; D018950:Lipopolysaccharide Receptors; D008070:Lipopolysaccharides; D005408:Flagellin; D061466:Lopinavir; C098320:efavirenz
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