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Immunopathogenesis of Metabolic Complications in Treated HIV Infection
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Reported by Jules Levin
CROI 2016 Feb 22-24 Boston
Suzanne Crowe
Associate Director, Burnet Institute
Consultant Infectious Diseases Physician, The Alfred Hospital
Melbourne
CROI February 2016
.....Potential strategies under investigation to reduce HIV-associated immune activation.............Links between gut microbiota , inflammatory pathways and visceral adiposity.....HIV - associated metabolic disorders (lipids, mitochondrial toxicity, bone abnormality)......These abnormalities increase the risk of clinical metabolic complications.....HIV+ individuals with virologic suppression on ART remain at risk of immune and metabolic dysregulation..... T cell activation is not completely eliminated by suppressive ART....increased in monocyte activation in HIV+ occur 4-12 years earlier than HIV- (1) Not on ART (12 yrs earlier) (2) On ART, VL<20 (4 yrs earlier)...... HIV infection and normal ageing share immune and clinical changes..... Colonic and systemic inflammation persist in chronic HIV+ with VS .....Tissue macrophages from AIDS pts productively infected with HIV and/ or CMV a immune activation .....Pro-inflammatory macrophages accumulate in colon..... HIV increases glucose metabolic activity in CD16+ monocytes and is correlated with D-dimer levels [in adipose tissue: limb & belly fat]..... Oxidative stress is important in the pathogenesis of metabolic complications in HIV.... Mitochondrial dysfunction due to oxidative stress in monocytes from frail HIV+ men with VL<20...... Microbial translocation, HIV persistence and coinfections cause persistent innate immune activation.....Inflammatory role in pathogenesis of Non Alcoholic Steatohepatitis (NASH)
WEBCAST:http://www.croiwebcasts.org/console/player/29682?mediaType=audio&
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