title: (1→3)-β-d-Glucan: A Biomarker for Microbial Translocation in Individuals with Acute or Early HIV Infection?
abstract: BACKGROUND
  The extent of gut microbial translocation, which plays roles in HIV disease progression and non-AIDS comorbidities, appears to vary with the composition of the gut microbiome, particularly the presence ofLactobacillales, which reduce mucosal injury. While low proportions ofLactobacillalesin the distal gut microbiome are a very promising indicator of microbial translocation, measurement is expensive and complicated and not feasible for clinical routine. (1→3)-β-d-Glucan (BDG) is a component of most fungal cell walls and might be a surrogate marker forLactobacillalesproportion in the gut and a useful indicator of HIV-associated gut injury. This study evaluated BDG as a biomarker of gut integrity in adults with acute or early HIV infection (AEH).
  
  
  METHODS
  Study samples were collected longitudinally during study visits at weeks 0, 12, and 24 in a cohort of 11 HIV-infected men starting antiretroviral therapy during AEH. Blood plasma levels of BDG, soluble cluster of differentiation 14 (sCD14) and lipopolysaccharide (LPS) were measured and then correlated with the proportion ofLactobacillalesin the distal gut microbiome, as measured by 16s rDNA sequencing by using mixed-effects models with random intercepts.
  
  
  RESULTS
  Mean BDG and sCD14 levels across subjects were associated withLactobacillalesafter controlling for time effects and within-subjects correlations (p-values < 0.05), while LPS levels were not. Specifically, each point increase in mean BDG and sCD14 levels across participants was associated with 0.31 ± 0.14 and 0.03 ± 0.01 percent decrease in meanLactobacillalesproportions, respectively.
  
  
  CONCLUSIONS
  BDG and sCD14 may be indicators of lowLactobacillalesin the gut in adults with acute or early HIV infection, and serve as biomarkers of gut integrity and microbial translocation in HIV infection. Larger studies are needed to confirm our findings.
authors.affiliation: Department of Medicine, Division of Infectious Diseases, University of California San Diego, San Diego, CA, USA; Section of Infectious Diseases and Tropical Medicine, Department of Internal Medicine, Medical University of Graz, Graz, Austria; Department of Internal Medicine, Division of Pulmonology, Medical University of Graz, Graz, Austria.
authors.forename: Martin
authors.initials: M
authors.lastname: Hoenigl
authors.affiliation: Department of Medicine, Division of Infectious Diseases, University of California San Diego , San Diego, CA , USA.
authors.forename: Josué
authors.initials: J
authors.lastname: Pérez-Santiago
authors.affiliation: Department of Medicine, AntiViral Research Center, University of California San Diego , San Diego, CA , USA.
authors.forename: Masato
authors.initials: M
authors.lastname: Nakazawa
authors.affiliation: Department of Medicine, Division of Infectious Diseases, University of California San Diego , San Diego, CA , USA.
authors.forename: Michelli Faria
authors.initials: MF
authors.lastname: de Oliveira
authors.affiliation: Clinical Development, Associates of Cape Cod, Inc. , Falmouth, MA , USA.
authors.forename: Yonglong
authors.initials: Y
authors.lastname: Zhang
authors.affiliation: Clinical Development, Associates of Cape Cod, Inc. , Falmouth, MA , USA.
authors.forename: Malcolm A
authors.initials: MA
authors.lastname: Finkelman
authors.affiliation: Department of Medicine, Division of Infectious Diseases, University of California San Diego, San Diego, CA, USA; Department of Neurosciences, HIV Neurobehavioral Research Center, University of California San Diego, San Diego, CA, USA.
authors.forename: Scott
authors.initials: S
authors.lastname: Letendre
authors.affiliation: Department of Medicine, Division of Infectious Diseases, University of California San Diego , San Diego, CA , USA.
authors.forename: Davey
authors.initials: D
authors.lastname: Smith
authors.affiliation: Department of Medicine, Division of Infectious Diseases, University of California San Diego , San Diego, CA , USA.
authors.forename: Sara
authors.initials: S
authors.lastname: Gianella
keywords: HIV; Lactobacillales; acute HIV infection; beta-d-glucan; microbial translocation; microbiome