Metabolism Unit, Division of Endocrinology, Massachusetts General Hospital, 55 Fruit Street, LON-207, Boston, MA, 02114, USA.
Department of Neurology, Massachusetts General Hospital, Boston, USA.
Curr HIV/AIDS Rep. 2021 Feb;18(1):57-62. doi: 10.1007/s11904-020-00537-8. Epub 2021 Jan 19.
Gut dysfunction and resulting chronic low-grade inflammation have been linked to metabolic and chronic diseases in the general population. In this review, we present recently published studies of HIV-associated gut dysfunction and comorbidities including obesity, diabetes, cardiovascular disease, liver disease, and neurocognitive disease.
Biomarkers of microbial translocation, dysbiosis, or intestinal epithelial integrity have been used to investigate relationships between HIV-associated gut dysfunction and metabolic, cardiovascular, and neurologic complications. Many studies point to worsened comorbidities associated with gut dysfunction in people with HIV (PWH), but some studies show mixed results, and thus, the data are still inconclusive and limited to surrogate biomarkers rather than direct intestinal assessments. Inflammation and immune activation stemming from changes in intestinal epithelial integrity and dysbiosis are present in PWH and relate to metabolic, cardiovascular, and neurologic complications of HIV. However, future investigations, especially future studies that directly assess intestinal pathology, are needed to investigate the direct contributory role of gastrointestinal dysfunction to comorbidities of HIV.
肠道功能障碍和由此导致的慢性低度炎症与普通人群的代谢和慢性疾病有关。在这篇综述中，我们介绍了最近发表的与 HIV 相关的肠道功能障碍以及肥胖症、糖尿病、心血管疾病、肝病和神经认知疾病等共病的研究。
微生物易位、菌群失调或肠上皮完整性的生物标志物已被用于研究 HIV 相关肠道功能障碍与代谢、心血管和神经并发症之间的关系。许多研究表明 HIV 感染者（PWH）的肠道功能障碍与更严重的共病相关，但也有一些研究结果不一，因此数据仍不确定，且仅限于替代生物标志物，而非直接的肠道评估。源自肠上皮完整性改变和菌群失调的炎症和免疫激活存在于 PWH 中，与 HIV 的代谢、心血管和神经并发症相关。然而，需要进一步的研究，特别是直接评估肠道病理的研究，以探究胃肠道功能障碍对 HIV 共病的直接促成作用。
