Relationship between innate immunity, soluble markers and metabolic-clinical parameters in HIV+ patients ART treated with HIV-RNA<50 cp/mL.
BACKGROUND
The persistence of immune activation and inflammation in HIV patients with HIV-RNA (VL) undetectable causes many co-morbidities [1-3]. The aim of this study is to correlate monocytes (m) and NK cell activation levels, soluble markers and oxidative stress with clinical, biochemical and metabolic data in HIV-1 infected patients with VL≤50 copies (cp)/mL on antiretroviral therapy.


METHODS
Multicentre, cross-sectional study in patients with VL≤50 cp/mL and on antiretroviral therapy by at least six months. We studied: activation/homing markers (CD38, HLA-DR, CCR-2, PDL-1) on inflammatory, intermediate, proinflammatory m; activatory receptors NKp30, NKp46 and HLA-DR on NK cells; soluble inflammatory (sCD14, adiponectina, MCP-1) and stress oxidative markers (dRoms, antiRoms). Univariate analyses are performed with non-parametric and Pearson tests. The significant correlations were adjusted for possible known confounding factors (smoking, Cytomegalovirus IgG serology, Raltegravir, Protease Inhibitor [PI] therapy and HCV-RNA) with multivariate analysis.


RESULTS
In the 68 patients the positive correlation between age and antiRoms was significant also after adjustment for PI use (p=0.05). The% CD8+T was associated with% proinflammatory m (p=0.043) and with their expression of CCR2 mean fluorescence intensity (MFI) (p=0.012). The% NKp46+ was positively correlated with CD4+T count (p=0.001). The fibrinogen was positively associated with dRoms (p=0.052) and the positive correlation between triglycerides and antiRoms has been confirmed (p<0.001); the impact of antiRoms on HDL/triglycerides ratio (p=0.006) was observed after adjustment for PI use. The BMI was associated with smoking (p=0.011). Only the maraviroc-treated patients showed minimal arterial pressure, fibrinogen and antiRoms lower (p=0.001, 0.004 e 0.006) and sCD14 values higher (p=0.029).


CONCLUSIONS
Patients with long history of HIV infection and stable immunological and virological status showed interactions between acquired and innate immunity activation; moreover, the levels of some metabolic and inflammatory parameters correlate with oxidative stress values and innate immunity activation. The age, BMI and smoking impact metabolic and immunological parameters. The correlations between antiretroviral drugs and clinical-immunological parameters need further confirmations.
Infectious Diseases, Sanremo Hospital, Sanremo, Italy; Center of Excellence for Biomedical Research, University of Genoa, Sanremo, Italy.
Chiara
C
Dentone
DIMI, Center of Excellence for Biomedical Research, University of Genoa, Genoa, Italy.
Daniela
D
Fenoglio
Section of Biostatistics, University of Genoa, Genoa, Italy.
Alessio
A
Signori
Infectious Diseases, Galliera Hospital, Genoa, Italy.
Giovanni
G
Cenderello
Center of Excellence for Biomedical Research, University of Genoa, Genoa, Italy.
Alessia
A
Parodi
DIMES, Center of Excellence for Biomedical Research, University of Genoa, Genoa, Italy.
Federica
F
Bozzano
Infectious Diseases, La Spezia Hospital, La Spezia, Italy.
Michele
M
Guerra
Infectious Diseases, Savona Hospital, Savona, Italy.
Pasqualina
P
De Leo
Infectious Diseases, Albenga Hospital, Albenga, Italy.
Valentina
V
Bartolacci
Infectious Diseases, Alessandria Hospital, Alessandria, Italy.
Eugenio
E
Mantia
Infectious Diseases, Amedeo di Savoia Hospital, Torino, Italy.
Giancarlo
G
Orofino
Center of Excellence for Biomedical Research, University of Genoa, Genoa, Italy.
Francesca
F
Kalli
Immunology, Giannina Gaslini Institute, Genoa, Italy.
Francesco
F
Marras
DIBRIS, University of Genoa, Genoa, Italy.
Paolo
P
Fraccaro
DIBRIS, Center of Excellence for Biomedical Research, University of Genoa, Genoa, Italy.
Mauro
M
Giacomini
Infectious Diseases, Galliera Hospital, Genoa, Italy.
Giovanni
G
Cassola
UO Hygiene, San Martino Hospital IRCCS, Genoa, Italy.
Bianca
B
Bruzzone
Infectious Diseases, Sanremo Hospital, Sanremo, Italy.
Giuseppe
G
Ferrea
Infectious Diseases, San Martino Hospital IRCCS, Genoa, Italy; University of Genoa, Genoa, Italy.
Claudio
C
Viscoli
DIMI, University of Genoa, Genoa, Italy; Center of Excellence for Biomedical Research, San Martino Hospital, Genoa, Italy.
Gilberto
G
Filaci
Infectious Diseases, San Martino Hospital IRCCS, Genoa, Italy; Center of Excellence for Biomedical Research, University of Genoa, Genoa, Italy.
Andrea
A
De Maria
Infectious Diseases, San Martino Hospital IRCCS, Genoa, Italy; University of Genoa, Genoa, Italy.
Antonio
A
Di Biagio