title: Helicobacter pylori Coinfection Is Associated With Decreased Markers of Immune Activation in ART-Naive HIV-Positive and in HIV-Negative Individuals in Ghana.
abstract: BACKGROUND
  Helicobacter pylori coinfection in human immunodeficiency virus (HIV) patients has been associated with higher CD4+ cell counts and lower HIV-1 viral loads, with the underlying mechanisms being unknown. The objective of this study was to investigate the impact of H. pylori infection on markers of T-cell activation in HIV-positive and HIV-negative individuals.
  
  
  METHODS
  In a cross-sectional, observational study, HIV patients (n = 457) and HIV-negative blood donors (n = 79) presenting to an HIV clinic in Ghana were enrolled. Data on clinical and sociodemographic parameters, CD4+/CD8+ T-cell counts, and HIV-1 viral load were recorded. Helicobacter pylori status was tested using a stool antigen test. Cell surface and intracellular markers related to T-cell immune activation and turnover were quantified by flow cytometry and compared according to HIV and H. pylori status.
  
  
  RESULTS
  Helicobacter pylori infection was associated with decreased markers of CD4+ T-cell activation (HLA-DR+CD38+CD4+; 22.55% vs 32.70%; P = .002), cell proliferation (Ki67; 15.10% vs 26.80%; P = .016), and immune exhaustion (PD-1; 32.45% vs 40.00%; P = .005) in 243 antiretroviral therapy (ART)-naive patients, but not in 214 patients on ART. In HIV-negative individuals, H. pylori infection was associated with decreased frequencies of activated CD4+ and CD8+ T cells (6.31% vs 10.40%; P = .014 and 18.70% vs 34.85%, P = .006, respectively).
  
  
  CONCLUSIONS
  Our findings suggest that H. pylori coinfection effectuates a systemic immune modulatory effect with decreased T-cell activation in HIV-positive, ART-naive patients but also in HIV-negative individuals. This finding might, in part, explain the observed association of H. pylori infection with favorable parameters of HIV disease progression.
  
  
  BACKGROUND
  Clinicaltrials.gov NCT01897909.
authors.affiliation: Clinical Research Unit, Bernhard Nocht Institute for Tropical Medicine, Hamburg, Germany.
authors.forename: Kirsten Alexandra
authors.initials: KA
authors.lastname: Eberhardt
authors.affiliation: Kwame Nkrumah University of Science and Technology Komfo Anokye Teaching Hospital, Kumasi, Ghana.
authors.forename: Fred Stephen
authors.initials: FS
authors.lastname: Sarfo
authors.affiliation: Komfo Anokye Teaching Hospital, Kumasi, Ghana.
authors.forename: Albert
authors.initials: A
authors.lastname: Dompreh
authors.affiliation: Clinic of Gastroenterology, Hepatology and Infectious Diseases, Heinrich Heine University Düsseldorf.
authors.forename: Edmund Osei
authors.initials: EO
authors.lastname: Kuffour
authors.affiliation: Division of Infectious Diseases and Tropical Medicine, Medical Center of the University of Munich (Ludwig Maximilian University [LMU]) German Centre for Infection Research (partner site), Munich.
authors.forename: Christof
authors.initials: C
authors.lastname: Geldmacher
authors.affiliation: Clinical Research Unit, Bernhard Nocht Institute for Tropical Medicine, Hamburg, Germany.
authors.forename: Mareike
authors.initials: M
authors.lastname: Soltau
authors.affiliation: Clinical Research Unit, Bernhard Nocht Institute for Tropical Medicine, Hamburg, Germany.
authors.forename: Marei
authors.initials: M
authors.lastname: Schachscheider
authors.affiliation: Institute of Virology, University of Bonn Medical Centre.
authors.forename: Jan Felix
authors.initials: JF
authors.lastname: Drexler
authors.affiliation: Institute of Virology, University of Bonn Medical Centre.
authors.forename: Anna Maria
authors.initials: AM
authors.lastname: Eis-Hübinger
authors.affiliation: Clinic of Gastroenterology, Hepatology and Infectious Diseases, Heinrich Heine University Düsseldorf.
authors.forename: Dieter
authors.initials: D
authors.lastname: Häussinger
authors.affiliation: Kwame Nkrumah University of Science and Technology Komfo Anokye Teaching Hospital, Kumasi, Ghana.
authors.forename: George
authors.initials: G
authors.lastname: Bedu-Addo
authors.affiliation: Kwame Nkrumah University of Science and Technology Komfo Anokye Teaching Hospital, Kumasi, Ghana.
authors.forename: Richard Odame
authors.initials: RO
authors.lastname: Phillips
authors.affiliation: Kwame Nkrumah University of Science and Technology Komfo Anokye Teaching Hospital, Kumasi, Ghana.
authors.forename: Betty
authors.initials: B
authors.lastname: Norman
authors.affiliation: Clinical Research Unit, Bernhard Nocht Institute for Tropical Medicine, Hamburg, Germany Institute for Interdisciplinary Medicine, Asklepios Klinik St Georg, Hamburg, Germany.
authors.forename: Gerd Dieter
authors.initials: GD
authors.lastname: Burchard
authors.affiliation: Clinical Research Unit, Bernhard Nocht Institute for Tropical Medicine, Hamburg, Germany Clinic of Gastroenterology, Hepatology and Infectious Diseases, Heinrich Heine University Düsseldorf.
authors.forename: Torsten
authors.initials: T
authors.lastname: Feldt
mesh_terms: D000328:Adult; D015415:Biomarkers; D015496:CD4-Positive T-Lymphocytes / Q000737:chemistry / Q000276:immunology*; D060085:Coinfection / Q000473:pathology*; D003430:Cross-Sectional Studies; D005260:Female; D005869:Ghana; D015658:HIV Infections / Q000150:complications* / Q000473:pathology*; D016481:Helicobacter Infections / Q000150:complications* / Q000473:pathology*; D006801:Humans; D008297:Male; D008875:Middle Aged; D016176:T-Lymphocyte Subsets / Q000737:chemistry / Q000276:immunology*; D055815:Young Adult
chemical_list: D015415:Biomarkers
keywords: HIV/AIDS; Helicobacter pylori; immune activation; sub-Saharan Africa