Immune activation is associated with decreased thymic function in asymptomatic, untreated HIV-infected individuals

Background: Reduced thymic function causes poor immunological reconstitution in human immunodeficiency virus (HIV)-positive patients on combined antiretroviral therapy (cART).The association between immune activation and thymic function in asymptomatic HIV positive treatment-naive individuals has thus far not been investigated.Aims and objectives: To optimise a five-colour flow cytometric assay for measurement of thymic function by measuring recent thymic emigrants (RTEs) in treatment-naive HIV-infected patients and healthy controls and correlate results with levels of immune activation, CD4 counts and viral load.Methods: Blood obtained from 53 consenting HIV-positive individuals and 32 controls recruited from HIV prevention and testing clinic in Cape Town, South Africa. RTEs were measured (CD3+/CD4+/CD45RA+/CD31+/CD62L+) and levels were correlated with CD4 counts of HIV-infected individuals, log viral load and levels of immune activation (CD8+/CD38+ T-cells).Results: HIV-infected individuals had reduced frequencies of RTEs when compared to controls (p = 0.0035). Levels of immune activation were inversely correlated with thymic function(p = 0.0403), and the thymic function in HIV-infected individuals showed no significant correlation with CD4 counts (p = 0.31559) and viral load (p = 0.20628).Conclusions: There was impaired thymic function in HIV-infected individuals, which was associated with increased levels of immune activation. The thymic dysfunction was not associated with CD4 counts and viral load. Immune activation may result in inflammatory damage to the thymus and subsequent thymic dysfunction, and CD4 counts and viral load may not necessarily reflect thymic dysfunction in HIV.

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Pulmonary function in an international sample of HIV-positive, treatment-naïve adults with CD4 counts > 500 cells/μL: a substudy of the INSIGHT Strategic Timing of AntiRetroviral Treatment (START) trial

HIV Medicine ◽

10.1111/hiv.12240 ◽

2015 ◽

Vol 16 ◽

pp. 119-128 ◽

Cited By ~ 17

Author(s):

KM Kunisaki ◽

DE Niewoehner ◽

G Collins ◽

DE Nixon ◽

E Tedaldi ◽

...

Keyword(s):

Pulmonary Function ◽

Antiretroviral Treatment ◽

Hiv Positive ◽

Cd4 Counts ◽

Treatment Start ◽

Treatment Naïve ◽

Positive Treatment ◽

Start Trial

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Pharmacokinetics of maraviroc administered at 150 mg once daily in association with lopinavir/ritonavir in HIV-positive treatment-naive patients

Journal of Antimicrobial Chemotherapy ◽

10.1093/jac/dkt074 ◽

2013 ◽

Vol 68 (7) ◽

pp. 1686-1688 ◽

Cited By ~ 8

Author(s):

A. Calcagno ◽

S. Nozza ◽

D. G. de Requena ◽

A. Galli ◽

A. D'Avolio ◽

...

Keyword(s):

Hiv Positive ◽

Once Daily ◽

Treatment Naïve ◽

Positive Treatment

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Optimal time for initiating antiretroviral therapy (ART) in HIV-positive, treatment-naive children aged 24 to 59 months (2 to 5 years old)

10.1002/14651858.cd010309 ◽

2013 ◽

Cited By ~ 1

Author(s):

Nandi Siegfried ◽

Matthias Egger ◽

Mary-Ann Davies ◽

Martina Penazzato

Keyword(s):

Antiretroviral Therapy ◽

Optimal Time ◽

Hiv Positive ◽

Treatment Naïve ◽

Positive Treatment

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Latent TGF-β1 is Compartmentalized Between Blood and Seminal Plasma of HIV-Positive Men and Its Activation in Semen is Negatively Correlated with Viral Load and Immune Activation

American Journal of Reproductive Immunology ◽

10.1111/aji.12300 ◽

2014 ◽

Vol 73 (2) ◽

pp. 151-161 ◽

Cited By ~ 5

Author(s):

Jessica K. Kafka ◽

Brendan J.W. Osborne ◽

Prameet M. Sheth ◽

Aisha Nazli ◽

Sara Dizzell ◽

...

Keyword(s):

Viral Load ◽

Seminal Plasma ◽

Immune Activation ◽

Hiv Positive ◽

Tgf Β1 ◽

Hiv Positive Men

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Dolutegravir induced sub-acute hepatic failure in HIV positive treatment naïve man in Botswana

Case Reports in Internal Medicine ◽

10.5430/crim.v6n4p5 ◽

2019 ◽

Vol 6 (4) ◽

pp. 5

Author(s):

Godfrey Mutashambara Rwegerera ◽

Munashe Rimbi ◽

Vimbai Mudhina ◽

Marang Tiny Simone ◽

Moranodi Sefo ◽

...

Keyword(s):

Hepatic Failure ◽

Hepatic Injury ◽

Acute Hepatic Failure ◽

Hiv Positive ◽

Close Monitoring ◽

Naive Patient ◽

Treatment Naïve ◽

Positive Treatment

Dolutegravir associated hepatic failure has rarely been reported. Hepatic failure can occur either acutely or after few weeks as it happened in our patient. We report a case of 61 years old HIV-positive treatment naïve patient who started experiencing features of hepatic injury one month after starting Dolutegravir-based regimen. Patient presented late with overt hepatic failure. We emphasize the importance of close monitoring both at initiation and long-term so as identify patients with early hepatic injury and limit fatal outcomes which are potentially avoidable.

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Cognıtıve Assessment of Young Adults Before and After Inıtıatıon of Combınatıon Antıretrovıral Therapy

10.21203/rs.3.rs-467874/v1 ◽

2021 ◽

Author(s):

Özlem Gül ◽

Alper Gündüz ◽

Dilek Yıldız Sevgi ◽

Nuray Uzun ◽

İlyas Dökmetaş

Keyword(s):

Antiretroviral Therapy ◽

Cognitive Functions ◽

Cognitive Assessment ◽

Hiv Positive ◽

Combination Antiretroviral Therapy ◽

Factors Affecting ◽

Before And After ◽

Treatment Naïve ◽

Positive Treatment ◽

Moca Score

Abstract Background: This study aimed to evaluate cognitive functions and the factors affecting them in naive HIV-positive patients by Montreal Cognitive Assessment (MoCA) test before and after the initiation of combination antiretroviral therapy. Method: HIV-positive, treatment-naive patients monitored between January-June 2017 were included in the study. MoCA test was performed at the beginning and the 6th month of the treatment.Findings: Forty male patients were included in the study. The mean age was calculated as 29.1±4.0. When the factors affecting the MoCA score were examined, there was a significant relationship between the education level and the MoCA score. Smoking ,alcohol and substance did not have a meaningful impact on baseline MoCA values. A significant correlation was found between CD4 count and HIV RNA level and attention function. There was a significant increase in the total MoCA score and the MoCA subgroup scores at the end of the 6th month of the treatmentConclusion: MoCA test is one of the practical tests that can be applied in a short time period and it was found useful in evaluating the changes in the cognitive functions of HIV positive patients during antiretroviral treatment.

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Renal Function among HIV Infected Patients on Combination Antiretroviral Therapy: ALongitudinal Cohort Study

JOURNAL FOR CLINICAL AND DIAGNOSTIC RESEARCH ◽

10.7860/jcdr/2021/48493.14814 ◽

2021 ◽

Author(s):

Bijaya Kumar Behera ◽

Sritam Acharya ◽

Sukanta Kumar Jena ◽

Keshaba Chandra Budula

Keyword(s):

Renal Function ◽

T Cell ◽

Cell Count ◽

Cd4 T Cell ◽

Hiv Positive ◽

P Value ◽

Treatment Naïve ◽

Positive Treatment ◽

The Mean ◽

Cd4 T Cell Count

Introduction: A large number of Human Immunodeficiency Virus (HIV) infected patients are taking combination Antiretroviral Therapy (cART) worldwide as it has led to dramatic improvements in them with a decreased viral load as well as an increase in Cluster of Differentiation (CD4+) T cell count. Though the incidence of HIV associated Chronic Kidney Disease (CKD) has decreased with the use of effective cART, the prevalence of End Stage Renal Disease (ESRD) in HIV positive patients has increased due to the risen longevity owing to them. Aim: To study the renal function abnormalities in HIV infected patients and to compare the change in renal function of treatment naïve patients with patients on triple drug regimen (cART). Materials and Methods: This prospective longitudinal cohort study was conducted on 54 Enzyme Linked Immunosorbent Assay (ELISA) positive HIV patients belonging to the age group of 18-70 years of both the genders over a period of two years from August 2017 to September 2019 in MKCG Medical College and Hospital, Berhampur, Odisha, India. Forty nine HIV infected patients naive to cART and five patients on cART for a minimum period of three months were included in this study. All patients were treated with triple therapy regimens of either ZLN (Zidovudine 300 mg+Lamivudine 150 mg+Nevirapine 200 mg) or TLE (Tenofovir 300 mg+Lamivudine 150+Efavirenz 600 mg) daily; in a single dose at bed time. Renal function parameters like serum urea, serum creatinine, Creatinine Clearance (CrCl), estimated Glomerular Filtration Rate (eGFR) and CD4+ T cell count of treatment naive patients were compared with the same patients on cART after six months duration. GFR was calculated by Modification of Diet in Renal Disease (MDRD) equation. Results were analysed using the Statistical Package for the Social Sciences (SPSS) software for Windows Version 17.0. Results: Out of 54 patients, 53.7% (n=29) were males and 46.3% (n=25) were females. The mean CrCl of HIV positive patients on cART (79.09±25.705 mL/min) was higher than treatment naive (69.65±25.506 mL/min) patients and was highly significant (p-value=0.003). The mean eGFR of HIV positive patients on cART (102.711±26.9424 mL/min/1.73 m2) was higher than treatment naïve (90.189±28.2575 mL/min/1.73 m2) patients and was highly significant (p-value=0.003). The mean serum urea of HIV positive patients on cART (25.78± 4.721 mg/dL) was lower than HIV positive treatment naïve (26.19±4.742 mg/dL) patients but was non-significant (p-value=0.640). The mean serum creatinine of HIV positive patients on cART (0.815±0.1393 mg/dL) was lower than HIV positive treatment naïve patients (0.906±0.1687 mg/dL) and was also highly significant (p-value=0.003). The mean CD4+ T cell count of HIV positive patients on cART (401.63±225.816 cells/μL) was higher than HIV positive treatment naïve (287.13±198.263 cells/μL) patients and was very highly significant (p=0.001). Conclusion: Renal impairment (CrCl <60 mL/min) and eGFR (<60 mL/min/1.73 m2) were higher in HIV positive treatment naive patients than those on cART. Radiological parameters like size of the kidney and cortical echogenicity became normal after six months on cART.

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Incidence of neuropsychiatric side effects of efavirenz in HIV-positive treatment-naïve patients in public-sector clinics in the Eastern Cape

Southern African Journal of HIV Medicine ◽

10.4102/sajhivmed.v17i1.452 ◽

2016 ◽

Vol 17 (1) ◽

Cited By ~ 2

Author(s):

Razia Gaida ◽

Ilse Truter ◽

Christoffel Grobler

Keyword(s):

Public Sector ◽

Side Effects ◽

Third Party ◽

Hiv Positive ◽

Eastern Cape ◽

True Incidence ◽

Treatment Naïve ◽

Positive Treatment ◽

Neuropsychiatric Side Effects

Background: It is acknowledged that almost half of patients initiated on efavirenz will experience at least one neuropsychiatric side effect.Objectives: The aim was to determine the incidence and severity of neuropsychiatric side effects associated with efavirenz use in five public-sector primary healthcare clinics in the Eastern Cape.Method: The study was a prospective drug utilisation study. A total of 126 medical records were reviewed to obtain the required information. After baseline assessment, follow-up reviews were conducted at 4 weeks, 12 weeks and 24 weeks from 2014 to 2015.Results: The participant group was 74.60% female (n = 94), and the average age was 37.57±10.60 years. There were no neuropsychiatric side effects recorded for any patient. After the full follow-up period, there were a total of 49 non-adherent patients and one patient had demised. A non-adherent patient was defined as a patient who did not return to the clinic for follow-up assessment and medication refills 30 days or more after the appointed date. Some patients (n = 11) had sent a third party to the clinic to collect their antiretroviral therapy (ART). The clinic pharmacy would at times dispense a two-month supply of medication resulting in the patient presenting only every two months.Conclusion: Further pharmacovigilance studies need to be conducted to determine the true incidence of these side effects. Healthcare staff must be encouraged to keep complete records to ensure meaningful patient assessments. Patients being initiated on ART need to personally attend the clinic monthly for at least the first 6 months of treatment. Clinic staff should receive regular training concerning ART, including changes made to guidelines as well as reminders of side effects experienced.Keywords: neuropsychiatric; side effects; efavirenz; HIV-positive patients

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Evaluating the use of procalcitonin in an asymptomatic, HIV-infected antiretroviral therapy-naïve, South African cohort

Clinical Chemistry and Laboratory Medicine (CCLM) ◽

10.1515/cclm-2015-0549 ◽

2016 ◽

Vol 54 (3) ◽

Cited By ~ 2

Author(s):

Dineo V. Phatlhane ◽

Hayley Ipp ◽

Rajiv T. Erasmus ◽

Annalise E. Zemlin

Keyword(s):

T Cells ◽

Viral Load ◽

Antiretroviral Therapy ◽

Hiv Infection ◽

Immune Activation ◽

Serum Samples ◽

Cross Sectional ◽

Cd4 Counts ◽

Persistent Inflammation ◽

Significant Difference

AbstractThe chronic stage of human immunodeficiency virus (HIV) infection, although clinically asymptomatic, is characterized by activation of the immune system and persistent inflammation. Procalcitonin (PCT) has been studied in HIV infection as a marker of bacterial infection. Our aim was to assess the effect of persistent immune activation on PCT levels in asymptomatic treatment naïve HIV infected subjects.This was a cross-sectional study of 68 asymptomatic antiretroviral therapy-naive HIV infected participants and 42 uninfected controls. Stored serum samples were used to measure: PCT, interleukin-6 (IL-6), lipopolysaccharide binding protein (LBP), high sensitivity C-reactive protein (hsCRP), immunoglobulin G (IgG) and albumin. PCT was correlated with markers of: disease progression (CD4 count and viral load), immune activation (CD 38 on CD8+ T cells, IgG and LBP), inflammation (IL-6, hsCRP and albumin).IL-6, IgG and CD8/38 were all significantly increased while albumin and CD4 counts were significantly lower in the HIV infected group. PCT levels were not significantly different between the two groups. There was no significant difference in LBP and hsCRP; however, their levels were increased in both groups. PCT correlated only with LBP (p=0.0001). IL-6 and LBP correlated positively with hsCRP and IgG. Albumin correlated inversely with IL-6 and viral load. Only IgG and CD8/38 correlated inversely with CD4 counts.We demonstrated the activation of the innate (raised LBP), humoral (raised IgG) and cellular immune systems (increased CD8/38 T cells). Despite a state of persistent inflammation, PCT levels are not elevated in asymptomatic untreated HIV infection.

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