From Wasting to Obesity: The Contribution of Nutritional Status to Immune Activation in HIV Infection.
The impact of human immunodeficiency virus (HIV) infection on innate and adaptive immune activation occurs in the context of host factors, which serve to augment or dampen the physiologic response to the virus. Independent of HIV infection, nutritional status, particularly body composition, affects innate immune activation through a variety of conditions, including reduced mucosal barrier defenses and microbiome dysbiosis in malnutrition and the proinflammatory contribution of adipocytes and stromal vascular cells in obesity. Similarly, T-cell activation, proliferation, and cytokine expression are reduced in the setting of malnutrition and increased in obesity, potentially due to adipokine regulatory mechanisms restraining energy-avid adaptive immunity in times of starvation and exerting a paradoxical effect in overnutrition. The response to HIV infection is situated within these complex interactions between host nutritional health and immunologic function, which contribute to the varied phenotypes of immune activation among HIV-infected patients across a spectrum from malnutrition to obesity.
Division of Infectious Diseases Vanderbilt Institute for Global Health, Nashville, Tennessee.
John R
JR
Koethe
Department of Medicine, Vanderbilt University School of Medicine Vanderbilt Institute for Global Health, Nashville, Tennessee.
Douglas C
DC
Heimburger
Mwanza Research Centre, National Institute for Medical Research, Tanzania.
George
G
PrayGod
Faculty of Epidemiology and Population Health, London School of Hygiene and Tropical Medicine, United Kingdom.
Suzanne
S
Filteau
D000818:Animals; D002100:Cachexia / Q000209:etiology / Q000276:immunology*; D015658:HIV Infections / Q000150:complications / Q000276:immunology*; D006801:Humans; D009752:Nutritional Status; D009765:Obesity / Q000150:complications / Q000276:immunology*
HIV; adipose tissue; immune activation; inflammation; malnutrition; obesity