Altered Intestinal Permeability and Fungal Translocation in Ugandan Children With Human Immunodeficiency Virus.

Published on May 23, 2020in Clinical Infectious Diseases8.313
· DOI :10.1093/CID/CIZ561
Sahera Dirajlal-Fargo8
Estimated H-index: 8
(Case Western Reserve University),
Vanessa El-Kamari2
Estimated H-index: 2
(Case Western Reserve University)
+ 9 AuthorsGrace A. McComsey59
Estimated H-index: 59
(Case Western Reserve University)
BACKGROUND: Children with perinatally acquired HIV (PHIVs) face a lifelong cumulative exposure to HIV and ART. The relationship between gut integrity, microbial translocation and inflammation in PHIV is poorly understood. METHODS: This is a cross-sectional study in 57 PHIVs, 59 HIV exposed uninfected (HEUs) and 56 HIV unexposed uninfected (HIV-) children aged 2-10 years old in Uganda. PHIVs were on stable ART with HIV-1 RNA 0.05). Among PHIVs who were breastfed, levels of sCD163 and IL6 were higher than levels in PHIV who were not breastfed (p<0.05). Additionally, in PHIVs with a history of breastfeeding, sCD14, BDG, LBP, zonulin and I-FABP correlated with several markers of systemic inflammation including hsCRP, IL6, d-dimer, sTNFRI and II (p≤0.05). CONCLUSION: Despite viral suppression, PHIVs have evidence of altered gut permeability and fungal translocation. Intestinal damage and the resultant bacterial and fungal translocation in PHIVs may play a role in the persistent inflammation that leads to many end organ diseases in adults.
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