title: Gut epithelial barrier dysfunction in human immunodeficiency virus-hepatitis C virus coinfected patients: Influence on innate and acquired immunity.
abstract: Even in cases where viral replication has been controlled by antiretroviral therapy for long periods of time, human immunodeficiency virus (HIV)-infected patients have several non-acquired immunodeficiency syndrome (AIDS) related co-morbidities, including liver disease, cardiovascular disease and neurocognitive decline, which have a clear impact on survival. It has been considered that persistent innate and acquired immune activation contributes to the pathogenesis of these non-AIDS related diseases. Immune activation has been related with several conditions, remarkably with the bacterial translocation related with the intestinal barrier damage by the HIV or by hepatitis C virus (HCV)-related liver cirrhosis. Consequently, increased morbidity and mortality must be expected in HIV-HCV coinfected patients. Disrupted gut barrier lead to an increased passage of microbial products and to an activation of the mucosal immune system and secretion of inflammatory mediators, which in turn might increase barrier dysfunction. In the present review, the intestinal barrier structure, measures of intestinal barrier dysfunction and the modifications of them in HIV monoinfection and in HIV-HCV coinfection will be considered. Both pathogenesis and the consequences for the progression of liver disease secondary to gut microbial fragment leakage and immune activation will be assessed.
authors.affiliation: Mercedes Márquez, Clotilde Fernández Gutiérrez del Álamo, José Antonio Girón-González, Department of Internal Medicine, Infectious Disease Unit, Puerta del Mar University Hospital, University of Cadiz, 11009 Cádiz, Spain.
authors.forename: Mercedes
authors.initials: M
authors.lastname: Márquez
authors.affiliation: Mercedes Márquez, Clotilde Fernández Gutiérrez del Álamo, José Antonio Girón-González, Department of Internal Medicine, Infectious Disease Unit, Puerta del Mar University Hospital, University of Cadiz, 11009 Cádiz, Spain.
authors.forename: Clotilde
authors.initials: C
authors.lastname: Fernández Gutiérrez del Álamo
authors.affiliation: Mercedes Márquez, Clotilde Fernández Gutiérrez del Álamo, José Antonio Girón-González, Department of Internal Medicine, Infectious Disease Unit, Puerta del Mar University Hospital, University of Cadiz, 11009 Cádiz, Spain.
authors.forename: José Antonio
authors.initials: JA
authors.lastname: Girón-González
mesh_terms: D056704:Adaptive Immunity; D000818:Animals; D018988:Bacterial Translocation; D060085:Coinfection; D000069196:Gastrointestinal Microbiome; D006678:HIV / Q000276:immunology*; D015658:HIV Infections / Q000175:diagnosis / Q000276:immunology* / Q000382:microbiology / Q000821:virology; D016174:Hepacivirus / Q000276:immunology*; D006526:Hepatitis C / Q000175:diagnosis / Q000276:immunology* / Q000382:microbiology / Q000821:virology; D054884:Host-Pathogen Interactions; D006801:Humans; D007113:Immunity, Innate; D018928:Immunity, Mucosal; D007413:Intestinal Mucosa / Q000276:immunology* / Q000382:microbiology / Q000821:virology; D010539:Permeability; D011379:Prognosis
keywords: Acquired immunity; Gut barrier; Hepatitis C virus infection; Human immunodeficiency virus infection; Innate immunity
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