巨细胞病毒血清阳性与人类免疫缺陷病毒感染者和未感染者的微生物易位增加有关。
Cytomegalovirus Seropositivity Is Associated With Increased Microbial Translocation in People Living With Human Immunodeficiency Virus and Uninfected Controls.
机构信息
Chronic Viral Illness Service, McGill University Health Centre, Montreal, Quebec, Canada.
Infectious Diseases and Immunity in Global Health Program, Research Institute, McGill University Health Centre, Montreal, Quebec, Canada.
出版信息
Clin Infect Dis. 2020 Sep 12;71(6):1438-1446. doi: 10.1093/cid/ciz1001.
BACKGROUND
Cytomegalovirus (CMV) seropositivity and anti-CMV immunoglobulin G (IgG) levels are associated with adverse health outcomes in elderly populations. Among people living with human immunodeficiency virus (PLWH), CMV seropositivity has been associated with persistent CD8 T-cell elevation and increased risk of developing non-AIDS comorbidities despite long-term antiretroviral therapy (ART). Herein, we investigated whether CMV seropositivity and elevation of anti-CMV IgG levels were associated with increased epithelial gut damage, microbial translocation, and systemic inflammation.
METHODS
A total of 150 PLWH (79 ART-naive and 71 ART-treated) were compared to 26 without human immunodeficiency virus (HIV) infection (uninfected controls). Plasma markers of HIV disease progression, epithelial gut damage, microbial translocation, nonspecific B-cell activation, anti-CMV and anti-Epstein-Barr virus (EBV) IgG levels, and proinflammatory cytokines were measured.
RESULTS
CMV seropositivity and elevated anti-CMV IgG levels were associated with markers of epithelial gut damage, microbial translocation, and inflammation in PLWH and participants without HIV infection. In contrast, total nonspecific IgG, immunoglobulin M, immunoglobulin A, and anti-EBV IgG levels were not associated with these markers. CMV seropositivity was associated with markers of epithelial gut damage, microbial translocation, and inflammation independent of sociodemographic and behavioral characteristics of the study population.
CONCLUSIONS
CMV-seropositive people with and without HIV had increased epithelial gut damage, microbial translocation, and inflammation. Furthermore, anti-CMV IgG levels were independently associated with increased epithelial gut damage and microbial translocation. CMV coinfection may partially explain persistent gut damage, microbial translocation, and inflammation in ART-treated PLWH.
背景
巨细胞病毒 (CMV) 血清阳性和抗 CMV 免疫球蛋白 G (IgG) 水平与老年人群的不良健康结果相关。在人类免疫缺陷病毒 (PLWH) 人群中，CMV 血清阳性与持续的 CD8 T 细胞升高和发生非艾滋病合并症的风险增加相关，尽管进行了长期抗逆转录病毒治疗 (ART)。在此，我们研究了 CMV 血清阳性和抗 CMV IgG 水平升高是否与增加的上皮肠道损伤、微生物易位和全身炎症相关。
方法
共比较了 150 名 PLWH（79 名未接受 ART 的 PLWH 和 71 名接受 ART 的 PLWH）和 26 名未感染 HIV 的人（未感染对照组）。测量了 HIV 疾病进展、上皮肠道损伤、微生物易位、非特异性 B 细胞激活、抗 CMV 和抗 EBV IgG 水平以及促炎细胞因子的血浆标志物。
结果
CMV 血清阳性和抗 CMV IgG 水平升高与 PLWH 和未感染 HIV 的参与者的上皮肠道损伤、微生物易位和炎症标志物相关。相比之下，总非特异性 IgG、IgM、IgA 和抗 EBV IgG 水平与这些标志物无关。CMV 血清阳性与上皮肠道损伤、微生物易位和炎症标志物相关，与研究人群的社会人口统计学和行为特征无关。
结论
CMV 血清阳性的 HIV 感染者和未感染者均存在上皮肠道损伤、微生物易位和炎症增加。此外，抗 CMV IgG 水平与上皮肠道损伤和微生物易位增加独立相关。CMV 合并感染可能部分解释了接受 ART 的 PLWH 中持续的肠道损伤、微生物易位和炎症。
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