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Microbial translocation is associated with sustained failure in CD4+ T-cell reconstitution in HIV-infected patients on long-term highly active antiretroviral therapy

Marchetti, Giuliaa; Bellistrì, Giusi Ma; Borghi, Elisab; Tincati, Camillaa; Ferramosca, Stefaniac; La Francesca, Mariab; Morace, Giuliab; Gori, Andread; Monforte, Antonella d'Arminioa

doi: 10.1097/QAD.0b013e3283112d29
Research Letters

Patients with inefficient CD4+ T-cell recovery on virogically suppressive highly active antiretroviral therapy constitute a major clinical hurdle given the threat of HIV/AIDS disease progression. We show heightened circulating lipopolysaccharide associated with plasma enterobacterial DNA and highly activated Ki67+CD4+CD8+ in 24 immunologic-nonresponders (CD4+ T-cell ≤ 200; HIV-RNA ≤ 50) compared with 11 full responders (CD4+ T-cell ≥ 400; HIV-RNA ≤ 50). These data provide novel insight into INRs pathogenesis, since they correlate augmented systemic translocation of microbial bioproducts with T-cell hyperactivation.

aDepartment of Medicine, Surgery and Dentistry, Clinic of Infectious Diseases, ‘San Paolo’ Hospital, University of Milan, Milan, Italy

bDepartment of Public Health, Microbiology, Virology, University of Milan, Milan, Italy

cDepartment of Clinical Sciences, Chair of Infectious Diseases and Tropical Medicine, ‘Luigi Sacco’ Hospital, University of Milan, Milan, Italy

dDivision of Infectious Diseases, ‘San Gerardo’ Hospital, Monza, Italy.

Received 21 March, 2008

Revised 4 July, 2008

Accepted 17 July, 2008

Correspondence to Giulia Marchetti, MD, PhD, Department of Medicine, Surgery and Dentistry, Clinic of Infectious Diseases, ‘San Paolo’ Hospital, University of Milan, via A. di Rudinì, 8, 20142 Milan, Italy. Tel: +39 02 81843064; fax: +39 02 81843054; e-mail: giulia.marchetti@unimi.it

© 2008 Lippincott Williams & Wilkins, Inc.