Infectious Disease and Immunity in Global Health Program, Research Institute of McGill University Health Centre, 1001 Boulevard Décarie, Montreal, QC, H4A 3J1, Canada.
Chronic Viral Illness Service, McGill University Health Centre, Montreal, QC, Canada.
AIDS Res Ther. 2023 May 18;20(1):30. doi: 10.1186/s12981-023-00525-z.
Gut damage allows translocation of bacterial lipopolysaccharide (LPS) and fungal β-D-glucan (BDG) into the blood. This microbial translocation contributes to systemic inflammation and risk of non-AIDS comorbidities in people living with HIV, including those receiving antiretroviral therapy (ART). We assessed whether markers of gut damage and microbial translocation were associated with cognition in ART-treated PLWH.
Eighty ART-treated men living with HIV from the Positive Brain Health Now Canadian cohort were included. Brief cognitive ability measure (B-CAM) and 20-item patient deficit questionnaire (PDQ) were administered to all participants. Three groups were selected based on their B-CAM levels. We excluded participants who received proton pump inhibitors or antiacids in the past 3 months. Cannabis users were also excluded. Plasma levels of intestinal fatty acid binding protein (I-FABP), regenerating islet-derived protein 3 α (REG3α), and lipopolysaccharides (LPS = were quantified by ELISA, while 1-3-β-D-glucan BDG) levels were assessed using the Fungitell assay. Univariable, multivariable, and splines analyses were performed.
Plasma levels of I-FABP, REG3α, LPS and BDG were not different between groups of low, intermediate and high B-CAM levels. However, LPS and REG3α levels were higher in participants with PDQ higher than the median. Multivariable analyses showed that LPS association with PDQ, but not B-CAM, was independent of age and level of education. I-FABP, REG3α, and BDG levels were not associated with B-CAM nor PDQ levels in multivariable analyses.
In this well characterized cohort of ART-treated men living with HIV, bacterial but not fungal translocation was associated with presence of cognitive difficulties. These results need replication in larger samples.
肠道损伤可导致细菌脂多糖（LPS）和真菌β-D-葡聚糖（BDG）移位进入血液。这种微生物易位会导致接受抗逆转录病毒治疗（ART）的 HIV 感染者出现全身炎症和非艾滋病合并症的风险。我们评估了肠道损伤和微生物易位的标志物与接受 ART 治疗的 PLWH 认知功能之间的关系。
纳入了来自加拿大“积极大脑健康现在”队列的 80 名接受 ART 治疗的 HIV 男性感染者。所有参与者均接受了简短认知能力测量（B-CAM）和 20 项患者缺陷问卷（PDQ）的评估。根据他们的 B-CAM 水平选择了三个组。我们排除了过去 3 个月内接受质子泵抑制剂或抗酸剂治疗的参与者。也排除了大麻使用者。通过 ELISA 定量测定血浆中肠脂肪酸结合蛋白（I-FABP）、再生胰岛衍生蛋白 3α（REG3α）和脂多糖（LPS）水平，而 1-3-β-D-葡聚糖 BDG 水平则使用 Fungitell 测定法进行评估。进行了单变量、多变量和样条分析。
在 B-CAM 水平低、中、高的三组之间，血浆 I-FABP、REG3α、LPS 和 BDG 水平没有差异。然而，PDQ 高于中位数的参与者的 LPS 和 REG3α 水平更高。多变量分析表明，LPS 与 PDQ 的关联，而不是 B-CAM，与年龄和教育程度无关。在多变量分析中，I-FABP、REG3α 和 BDG 水平与 B-CAM 或 PDQ 水平均无关。
在这个经过良好特征描述的接受 ART 治疗的 HIV 男性感染者队列中，细菌易位而不是真菌易位与认知困难的存在有关。这些结果需要在更大的样本中进行复制。
