Helicobacter pylori infection rates in dyspeptic Serbian HIV-infected patients compared to HIV-negative controls

Helicobacter pylori infection does not belong to the spectrum of opportunistic infections in people living with HIV (PLHIV). To evaluate the Helicobacter pylori infection prevalence rate trends in HIV co-infected individuals in comparison to the HIV-negative population, we compared histopathological findings of H. pylori positive gastritis (gastritis topography and histopathology) between 303 PLHIV and 2642 HIV-negative patients who underwent esophagogastroduodenoscopy (EGD) between 1993 and 2014 due to dyspeptic symptoms. The prevalence of H. pylori infection was significantly higher in HIV-negative controls than in PLHIV (50.2% vs. 28.1%). A significantly positive linear trend of H. pylori co-infection in PLHIV was revealed in the observed period (b = 0.030, SE = 0.011, p = 0.013), while this trend was significantly negative in HIV-negative patients (b = - 0.027, SE = 0.003, p < 0.001). Patients with HIV/H. pylori co-infection had significantly higher CD4+ T cell counts and more often had undetectable HIV viremia, due to successful anti-retroviral therapy (ART). Stomach histopathological findings differed between HIV co-infected and H. pylori mono-infected patients. Our findings confirm that the ART has changed the progression of HIV infection, leading to a significant increase in the prevalence of H. pylori infection in dyspeptic PLHIV over time. Our data also suggests that a functional immune system may be needed for H. pylori-induced human gastric mucosa inflammation.

Download Full-text

The increasing prevalence of HIV/Helicobacter pylori co-infection over time, along with the evolution of antiretroviral therapy (ART)

PeerJ ◽

10.7717/peerj.3392 ◽

2017 ◽

Vol 5 ◽

pp. e3392

Author(s):

Aleksandra Radovanović Spurnić ◽

Branko Brmbolić ◽

Zorica Stojšić ◽

Tatijana Pekmezović ◽

Zoran Bukumirić ◽

...

Keyword(s):

Helicobacter Pylori ◽

Antiretroviral Therapy ◽

Highly Active Antiretroviral Therapy ◽

Bacterial Infections ◽

Gastrointestinal Symptoms ◽

Early Period ◽

People Living With Hiv ◽

H Pylori ◽

Negative Controls ◽

Hiv Negative

Helicobacter pylori (H. pylori) is one of the most common human bacterial infections with prevalence rates between 10–80% depending upon geographical location, age and socioeconomic status. H. pylori is commonly found in patients complaining of dyspepsia and is a common cause of gastritis. During the course of their infection, people living with HIV (PLHIV) often have a variety of gastrointestinal symptoms including dyspepsia and while previous studies have reported HIV and H. pylori co-infection, there has been little data clarifying the factors influencing this. The aim of this case-control study was to document the prevalence of H. pylori co-infection within the HIV community as well as to describe endoscopic findings, gastritis topography and histology, along with patient demographic characteristics across three different periods of time during which antiretroviral therapy (ART) has evolved, from pre- highly active antiretroviral therapy (HAART) to early and modern HAART eras. These data were compared to well-matched HIV negative controls. Two hundred and twelve PLHIV were compared with 1,617 controls who underwent their first esophagogastroduodenoscopy (EGD) to investigate dyspepsia. The prevalence of H. pylori co-infection among PLHIV was significantly higher in the early (30.2%) and modern HAART period (34.4%) compared with those with coinfection from the pre-HAART period (18.2%). The higher rates seen in patients from the HAART eras were similar to those observed among HIV negative controls (38.5%). This prevalence increase among co-infected patients was in contrast to the fall in prevalence observed among controls, from 60.7% in the early period to 52.9% in the second observed period. The three PLHIV co-infected subgroups differed regarding gastritis topography, morphology and pathology. This study suggests that ART has an important impact on the endoscopic and histological features of gastritis among HIV/H. pylori co-infected individuals, raising the possibility that H. pylori-induced gastritis could be an immune restoration disease.

Download Full-text

Excess burden of age-associated comorbidities among people living with HIV in British Columbia, Canada: a population-based cohort study

BMJ Open ◽

10.1136/bmjopen-2020-041734 ◽

2021 ◽

Vol 11 (1) ◽

pp. e041734

Author(s):

Ni Gusti Ayu Nanditha ◽

Adrianna Paiero ◽

Hiwot M Tafessu ◽

Martin St-Jean ◽

Taylor McLinden ◽

...

Keyword(s):

British Columbia ◽

Cohort Study ◽

Population Based ◽

Age At Diagnosis ◽

Secondary Outcome ◽

People Living With Hiv ◽

Prevalence Trends ◽

Living With Hiv ◽

Negative Controls ◽

Hiv Negative

ObjectivesAs people living with HIV (PLWH) live longer, morbidity and mortality from non-AIDS comorbidities have emerged as major concerns. Our objective was to compare prevalence trends and age at diagnosis of nine chronic age-associated comorbidities between individuals living with and without HIV.Design and settingThis population-based cohort study used longitudinal cohort data from all diagnosed antiretroviral-treated PLWH and 1:4 age-sex-matched HIV-negative individuals in British Columbia, Canada.ParticipantsThe study included 8031 antiretroviral-treated PLWH and 32 124 HIV-negative controls (median age 40 years, 82% men). Eligible participants were ≥19 years old and followed for ≥1 year during 2000 to 2012.Primary and secondary outcome measuresThe presence of non-AIDS-defining cancers, diabetes, osteoarthritis, hypertension, Alzheimer’s and/or non-HIV-related dementia, cardiovascular, kidney, liver and lung diseases were identified from provincial administrative databases. Beta regression assessed annual age-sex-standardised prevalence trends and Kruskal-Wallis tests compared the age at diagnosis of comorbidities stratified by rate of healthcare encounters.ResultsAcross study period, the prevalence of all chronic age-associated comorbidities, except hypertension, were higher among PLWH compared with their community-based HIV-negative counterparts; as much as 10 times higher for liver diseases (25.3% vs 2.1%, p value<0.0001). On stratification by healthcare encounter rates, PLWH experienced most chronic age-associated significantly earlier than HIV-negative controls, as early as 21 years earlier for Alzheimer’s and/or dementia.ConclusionsPLWH experienced higher prevalence and earlier age at diagnosis of non-AIDS comorbidities than their HIV-negative controls. These results stress the need for optimised screening for comorbidities at earlier ages among PLWH, and a comprehensive HIV care model that integrates prevention and treatment of chronic age-associated conditions. Additionally, the robust methodology developed in this study, which addresses concerns on the use of administrative health data to measure prevalence and incidence, is reproducible to other settings.

Download Full-text

HIV status alters disease severity and immune cell responses in beta variant SARS-CoV-2 infection wave

eLife ◽

10.7554/elife.67397 ◽

2021 ◽

Vol 10 ◽

Author(s):

Farina Karim ◽

Inbal Gazy ◽

Sandile Cele ◽

Yenzekile Zungu ◽

Robert Krause ◽

...

Keyword(s):

Hiv Infection ◽

Disease Severity ◽

Immune Cell ◽

Supplemental Oxygen ◽

People Living With Hiv ◽

Cell Counts ◽

Cell Changes ◽

Living With Hiv ◽

Second Wave ◽

Hiv Negative

There are conflicting reports on the effects of HIV on COVID-19. Here we analyzed disease severity and immune cell changes during and after SARS-CoV-2 infection in 236 participants from South Africa, of which 39% were people living with HIV (PLWH), during the first and second (beta dominated) infection waves. The second wave had more PLWH requiring supplemental oxygen relative to HIV negative participants. Higher disease severity was associated with low CD4 T cell counts and higher neutrophil to lymphocyte ratios (NLR). Yet, CD4 counts recovered and NLR stabilized after SARS-CoV-2 clearance in wave 2 infected PLWH, arguing for an interaction between SARS-CoV-2 and HIV infection leading to low CD4 and high NLR. The first infection wave, where severity in HIV negative and PLWH was similar, still showed some HIV modulation of SARS-CoV-2 immune responses. Therefore, HIV infection can synergize with the SARS-CoV-2 variant to change COVID-19 outcomes.

Download Full-text

Occurrence of Accelerated Epigenetic Aging and Methylation Disruptions in Human Immunodeficiency Virus Infection Before Antiretroviral Therapy

The Journal of Infectious Diseases ◽

10.1093/infdis/jiaa599 ◽

2020 ◽

Author(s):

Chen Xi Yang ◽

Emma Schon ◽

Ma’en Obeidat ◽

Michael S Kobor ◽

Lisa McEwen ◽

...

Keyword(s):

Dna Methylation ◽

Human Immunodeficiency Virus ◽

T Cell ◽

Antiretroviral Therapy ◽

Cellular Aging ◽

Epigenetic Clock ◽

Cell Counts ◽

Immunodeficiency Virus ◽

Negative Controls ◽

Hiv Negative

Abstract Background Whether accelerated aging develops over the course of chronic human immunodeficiency virus (HIV) infection or can be observed before significant immunosuppression on is unknown. We studied DNA methylation in blood to estimate cellular aging in persons living with HIV (PLWH) before the initiation of antiretroviral therapy (ART). Methods A total of 378 ART-naive PLWH who had CD4 T-cell counts >500/µL and were enrolled in the Strategic Timing of Antiretroviral Therapy trial (Pulmonary Substudy) were compared with 34 HIV-negative controls. DNA methylation was performed using the Illumina MethylationEPIC BeadChip. Differentially methylated positions (DMPs) and differentially methylated regions (DMRs) in PLWH compared with controls were identified using a robust linear model. Methylation age was calculated using a previously described epigenetic clock. Results There were a total of 56 639 DMPs and 6103 DMRs at a false discovery rate of <0.1. The top 5 DMPs corresponded to genes NLRC5, VRK2, B2M, and GPR6 and were highly enriched for cancer-related pathways. PLWH had significantly higher methylation age than HIV-negative controls (P = .001), with black race, low CD4 and high CD8 T-cell counts, and duration of HIV being risk factors for age acceleration. Conclusions PLWH before the initiation of ART and with preserved immune status show evidence of advanced methylation aging.

Download Full-text

Cognitive function, depressive symptoms and syphilis in HIV-positive and HIV-negative individuals

International Journal of STD & AIDS ◽

10.1177/0956462418817612 ◽

2019 ◽

Vol 30 (5) ◽

pp. 440-446 ◽

Cited By ~ 2

Author(s):

Davide De Francesco ◽

Alan Winston ◽

Jonathan Underwood ◽

Fiona V Cresswell ◽

Jane Anderson ◽

...

Keyword(s):

Depressive Symptoms ◽

Cognitive Function ◽

Cognitive Test ◽

People Living With Hiv ◽

Serological Tests ◽

Syphilis Infection ◽

Patient Health ◽

History Of ◽

Negative Controls ◽

Hiv Negative

We evaluated associations between history of syphilis infection and both cognitive function and depressive symptoms in people living with HIV (PLHIV) and comparable HIV-negative controls. Syphilis serological tests, cognitive function and depression were assessed in PLHIV and controls participating in the Pharmacokinetic and Clinical Observations in People Over Fifty study. Cognitive test scores were converted to demographically adjusted T-scores (mean = 50, SD = 10) and then averaged to obtain a global T-score. Severity of depressive symptoms was assessed via the Patient Health Questionnaire-9. Associations of syphilis with global T-scores and depression were assessed using median regression. The 623 PLHIV and 246 HIV-negative controls were predominantly male (89.3% and 66.5%) with median age (interquartile range [IQR]) of 57 (53–63) and 58 (53–63) years, respectively. PLHIV had lower global cognitive T-scores (median [IQR] 48.7 [45.1, 52.1] versus 50.5 [47.0, 53.9], p < 0.001), more severe depressive symptoms (median [IQR] 4 [1, 10] versus 1 [0, 3], p < 0.001) and were more likely to report history of syphilis infection (22.0% versus 8.1%) than controls. There was no significant association between history of syphilis and global cognitive function in either PLHIV (p = 0.69) or controls (p = 0.10). Participants with a history of syphilis had more severe depressive symptoms (median [IQR] 4 [1, 9] versus 2 [0, 8], p = 0.03); however, the association became non-significant (p = 0.62) after adjusting for HIV status and potential confounders. Despite the higher prevalence of syphilis infection in PLHIV, there was no evidence of an association between history of syphilis infection and impaired cognitive function nor depressive symptoms after accounting for potential confounders.

Download Full-text

Depression, lifestyle factors and cognitive function in people living with HIV and comparable HIV-negative controls

HIV Medicine ◽

10.1111/hiv.12714 ◽

2019 ◽

Vol 20 (4) ◽

pp. 274-285 ◽

Cited By ~ 6

Author(s):

D De Francesco ◽

J Underwood ◽

E Bagkeris ◽

M Boffito ◽

FA Post ◽

...

Keyword(s):

Cognitive Function ◽

Lifestyle Factors ◽

People Living With Hiv ◽

Living With Hiv ◽

Negative Controls ◽

Hiv Negative

Download Full-text

CSF concentrations of soluble TREM2 as a marker of microglial activation in HIV-1 infection

Neurology Neuroimmunology & Neuroinflammation ◽

10.1212/nxi.0000000000000512 ◽

2018 ◽

Vol 6 (1) ◽

pp. e512 ◽

Cited By ~ 17

Author(s):

Magnus Gisslén ◽

Amanda Heslegrave ◽

Elena Veleva ◽

Aylin Yilmaz ◽

Lars-Magnus Andersson ◽

...

Keyword(s):

T Cell ◽

Microglial Activation ◽

Neuronal Injury ◽

Cell Loss ◽

Cross Sectional ◽

Neurofilament Light ◽

Cell Counts ◽

Negative Controls ◽

Hiv 1 ◽

Hiv Negative

ObjectiveTo explore changes in CSF sTREM2 concentrations in the evolving course of HIV-1 infection.MethodsIn this retrospective cross-sectional study, we measured concentrations of the macrophage/microglial activation marker sTREM2 in CSF samples from 121 HIV-1–infected adults and 11 HIV-negative controls and examined their correlations with other CSF and blood biomarkers of infection, inflammation, and neuronal injury.ResultsCSF sTREM2 increased with systemic and CNS HIV-1 disease severity, with the highest levels found in patients with HIV-associated dementia (HAD). In untreated HIV-1–infected patients without an HAD diagnosis, levels of CSF sTREM2 increased with decreasing CD4+ T-cell counts. CSF concentrations of both sTREM2 and the neuronal injury marker neurofilament light protein (NFL) were significantly associated with age. CSF sTREM2 levels were also independently correlated with CSF NFL. Notably, this association was also observed in HIV-negative controls with normal CSF NFL. HIV-infected patients on suppressive antiretroviral treatment had CSF sTREM2 levels comparable to healthy controls.ConclusionsElevations in CSF sTREM2 levels, an indicator of macrophage/microglial activation, are a common feature of untreated HIV-1 infection that increases with CD4+ T-cell loss and reaches highest levels in HAD. The strong and independent association between CSF sTREM2 and CSF NFL suggests a linkage between microglial activation and neuronal injury in HIV-1 infection. CSF sTREM2 has the potential of being a useful biomarker of innate CNS immune activation in different stages of untreated and treated HIV-1 infection.

Download Full-text

Trans Cohorts Metabolomic Modulation Following Long-Term Successful Therapy in HIV-Infection

10.1101/2021.07.14.21260539 ◽

2021 ◽

Author(s):

Flora Mikaeloff ◽

Sara Svensson-Akusjarvi ◽

George Mondinde Ikomey ◽

Shuba Krishnan ◽

Maike Sperk ◽

...

Keyword(s):

Cell Model ◽

Antiretroviral Drugs ◽

Metabolic Reprogramming ◽

Metabolic Adaptation ◽

People Living With Hiv ◽

Low Grade ◽

Successful Therapy ◽

Negative Controls ◽

Hiv Negative

Despite successful combination antiretroviral therapy (cART), persistent low-grade immune activation together with inflammation and toxic antiretroviral drugs can lead to long-lasting metabolic adaptation in people living with HIV (PLWH). The successful short-term cART reported abnormalities in the metabolic reprogramming in PLWH, but the long-term consequences are unknown. This study investigated alterations in the plasma metabolic profiles by comparing PLWH and matched HIV-negative controls (HC) from Cameroon and India. We used untargeted and targeted LC-MS/MS-based metabolic profiling in PLWH with long-term (>5years) successful therapy in a trans cohorts approach. Advanced statistical and bioinformatics analyses showed altered amino acid metabolism, more specifically to glutaminolysis in PLWH with therapy than HIV-negative controls that can lead to excitotoxicity in both the cohorts. A significantly lower level of neurosteroids was observed in both cohorts and could potentiate neurological impairments in PLWH. The modulation of cellular glutaminolysis promoted increased cell death and latency reversal in pre-monocytic HIV-1 latent cell model U1, which may be essential for the clearance of the inducible reservoir in HIV-integrated cells. Our patient-based metabolomics and in vitro study, therefore, highlight the importance of altered glutaminolysis in PLWH that can be linked accelerated neurocognitive aging and metabolic reprogramming in latently infected cells.

Download Full-text

Electrocardiographic and echocardiographic abnormalities in urban African people living with HIV in South Africa

PLoS ONE ◽

10.1371/journal.pone.0244742 ◽

2021 ◽

Vol 16 (2) ◽

pp. e0244742

Author(s):

Geert V. T. Roozen ◽

Ruchika Meel ◽

Joyce Peper ◽

William D. F. Venter ◽

Roos E. Barth ◽

...

Keyword(s):

South Africa ◽

Viral Load ◽

Left Ventricular Mass ◽

Qt Interval ◽

Left Ventricular ◽

Hiv Positive ◽

People Living With Hiv ◽

Living With Hiv ◽

Negative Controls ◽

Hiv Negative

Background Studies from high income countries report that HIV-positive people have an impaired systolic and diastolic cardiac function compared to HIV-negative people. It is unclear if results can be translated directly to the Sub-Saharan Africa context. This study assesses electro- and echocardiographic characteristics in an urban African population, comparing HIV-positive people (treated and not yet treated) with HIV-negative controls. Methods We conducted a cross-sectional study in Johannesburg, South Africa. We enrolled HIV-positive participants from three randomized controlled trials that had recruited participants from routine HIV testing programs. HIV-negative controls were recruited from the community. Data were collected on demographics, cardiovascular risk factors, medical history and electrocardiographic and echocardiographic characteristics. Results In total, 394 HIV-positive participants and 153 controls were enrolled. The mean age of HIV-positive participants was 40±9 years (controls: 35±10 years), and 34% were male (controls: 50%). Of HIV-positive participants 36% were overweight or obese (controls: 44%), 23% had hypertension (controls: 28%) and 12% were current smoker (controls: 37%). Median time since HIV diagnosis was 6.0 years (IQR 2.3–10.0) and median treatment duration was 4.0 years (IQR 0.0–8.0), 50% had undetectable viral load. The frequency of anatomical cardiac abnormalities was low and did not differ between people with and without HIV. We observed no relation between HIV or anti-retroviral therapy (ART) and systolic or diastolic heart function. There was an association between ART use and corrected QT interval: +11.8 ms compared to HIV-negative controls (p<0.01) and +18.9 ms compared to ART-naïve participants (p = 0.01). We also observed a higher left ventricular mass index in participants on ART (+7.8 g/m2, p<0.01), but this association disappeared after adjusting for CD4 cell count, viral load and HIV-duration. Conclusion The low number of major cardiac abnormalities in this relatively young, well managed urban African HIV-positive population is reassuring. The increase in corrected QT interval and left ventricular mass may contribute to higher cardiac mortality and morbidity in people living with HIV in the long term.

Download Full-text

A study of bone mineral density among people living with HIV in India and its correlation with CD4 count

International Journal of Research in Medical Sciences ◽

10.18203/2320-6012.ijrms20170153 ◽

2017 ◽

Vol 5 (2) ◽

pp. 563 ◽

Cited By ~ 2

Author(s):

Kamal K. Sawlani ◽

Sushrut Singh ◽

Shyam C. Chaudhary ◽

D. Himanshu Reddy ◽

Kauser Usman ◽

...

Keyword(s):

Cd4 Count ◽

Hiv Positive ◽

Control Group ◽

People Living With Hiv ◽

Care Hospital ◽

Mineral Density ◽

Hiv Patients ◽

Negative Controls ◽

Prevalence Of Osteoporosis ◽

Hiv Negative

Background: Data on the prevalence of osteoporosis in HIV patients in Asian population is scarce this study was done to find out the prevalence of osteoporosis in HIV infected patients and its correlation with CD4 counts.Methods: This cross- sectional study was conducted in NACO- ART center of tertiary care hospital. Total 115 HIV patients were included in this study which were divided into ART naive (n= 69) and patients taking ART (n= 46). We analysed BMD by DEXA in 115 HIV positive patients and 78 HIV negative age and sex matched controls. Correlation of BMD with a CD4 count and ART regimen was studied.Results: BMD was found to be low in HIV positive patients. T score in HIV positive patients was significantly lower (p<0.05) as compared to the HIV negative control group. The prevalence of osteopenia and osteoporosis in HIV positive patients was 50.4% and 29.6% respectively, as compared to 23.1% and 2.6% in HIV negative controls. BMD showed relation with CD4 count. We did not find any statistical difference between any ART regimen and BMD.Conclusions: The prevalence of osteopenia and osteoporosis in HIV infected cases was higher as compared to HIV negative controls and higher in ART group as compared to ART naïve group. Low BMD levels show correlation with low CD4 count. We recommend that HIV positive patients especially with advanced stage of disease, low CD4 count should be screened for low BMD by DEXA scan for osteoporosis and managed accordingly

Download Full-text