Pattern of microbial translocation in patients living with HIV-1 from Vietnam, Ethiopia and Sweden.
BACKGROUND
The role of microbial translocation (MT) in HIV patients living with HIV from low- and middle-income countries (LMICs) is not fully known. The aim of this study is to investigate and compare the patterns of MT in patients from Vietnam, Ethiopia and Sweden.


METHODS
Cross-sectional samples were obtained from treatment-naïve patients living with HIV-1 and healthy controls from Vietnam (n=83; n=46), Ethiopia (n=9492; n=50) and Sweden (n=51; n=19). Longitudinal samples were obtained from a subset of the Vietnamese (n=24) in whom antiretroviral therapy (ART) and tuberculostatics were given. Plasma lipopolysaccharide (LPS), sCD14 and anti-flagellin IgG were determined by the endpoint chromogenic Limulus Amebocyte Assay and enzyme-linked immunosorbent assay.


RESULTS
All three biomarkers were significantly increased in patients living with HIV-1 from all countries as compared to controls. No differences were found between males and females. Vietnamese and Ethiopian patients had significantly higher levels of anti-flagellin IgG and LPS, as compared to Swedes. ART reduced these levels for the Vietnamese. Vietnamese patients given tuberculostatics at initiation of ART had significantly lower levels of anti-flagellin IgG and higher sCD14. The biomarkers were lower in Vietnamese who did not develop opportunistic infection.


CONCLUSIONS
Higher MT is common in patients living with HIV compared to healthy individuals, and in patients from LMICs compared to patients from a high-income country. Treatment with tuberculostatics decreased MT while higher levels of MT are associated with a poorer clinical outcome.
Division of Clinical Microbiology, Department of Laboratory Medicine, Karolinska Institute, Karolinska University Hospital, Stockholm, Sweden; Samir.abdurahman@ki.se.
Samir
S
Abdurahman
Department of Medicine, Unit of Infectious Diseases, Karolinska Institutet, Karolinska University Hospital, Sweden.
Babilonia
B
Barqasho
Department of Medicine, Unit of Infectious Diseases, Karolinska Institutet, Karolinska University Hospital, Sweden.
Piotr
P
Nowak
Infectious Diseases Department, Bach Mai Hospital, Hanoi, Vietnam.
Do Duy
do D
Cuong
Department of Medicine, Faculty of Medicine, Addis Ababa University, Ethiopia.
Wondwossen
W
Amogné
Division of Global Health (IHCAR), Department of Public Health Sciences, Karolinska Institutet, Stockholm, Sweden; Oxford University Clinical Research Unit (OUCRU), Hanoi, Vietnam.
Mattias
M
Larsson
Department of Medicine, Unit of Infectious Diseases, Karolinska Institutet, Karolinska University Hospital, Sweden.
Lars
L
Lindquist
Division of Global Health (IHCAR), Department of Public Health Sciences, Karolinska Institutet, Stockholm, Sweden.
Gaetano
G
Marrone
Division of Clinical Microbiology, Department of Laboratory Medicine, Karolinska Institute, Karolinska University Hospital, Stockholm, Sweden; Department of Medicine, Unit of Infectious Diseases, Karolinska Institutet, Karolinska University Hospital, Sweden.
Anders
A
Sönnerborg
D017088:AIDS-Related Opportunistic Infections / Q000276:immunology / Q000382:microbiology; D000328:Adult; D018988:Bacterial Translocation / Q000502:physiology*; D004797:Enzyme-Linked Immunosorbent Assay; D005002:Ethiopia / Q000453:epidemiology; D005260:Female; D005408:Flagellin / Q000276:immunology; D015658:HIV Infections / Q000382:microbiology* / Q000503:physiopathology; D015497:HIV-1; D006801:Humans; D007074:Immunoglobulin G / Q000276:immunology; D018950:Lipopolysaccharide Receptors / Q000097:blood; D008070:Lipopolysaccharides / Q000097:blood; D008297:Male; D008875:Middle Aged; D013548:Sweden / Q000453:epidemiology; D014744:Vietnam / Q000453:epidemiology; D019562:Viral Load
D007074:Immunoglobulin G; D018950:Lipopolysaccharide Receptors; D008070:Lipopolysaccharides; D005408:Flagellin
HIV in Ethiopia; HIV in Sweden; HIV in Vietnam; LPS; immune activation; microbial translocation; sCD14; treatment-naïve patients living with HIV