Monocyte activation and gut barrier dysfunction in South African youth on antiretroviral therapy and their associations with endothelial dysfunction

Sahera Dirajlal-Fargo, Jiao Yu, Zainab Albar, Abdus Sattar, Sana Mahtab, Jennifer Jao, Landon Myer, Heather J. Zar, Grace A. McComsey

Research output: Contribution to journalArticlepeer-review

8 Scopus citations

Abstract

Background:There is evidence for endothelial dysfunction in youth living with perinatally acquired HIV (YLPHIV). However, little data exist on its mechanisms.Methods:YLPHIV and age-matched HIV-uninfected (HIV-) youth enrolled in the Cape Town Adolescent Antiretroviral Cohort in South Africa between 9 and 14 years of age were included. YLPHIV were on antiretroviral therapy more than 6 months with viral load less than 400 copies/ml at baseline and 24 months. Serum biomarkers of systemic inflammation, monocyte activation, intestinal integrity, and oxidized LDL-cholesterol were measured at baseline and after 24 months. Endothelial function was measured at 24 months using reactive hyperemic index (RHI); endothelial dysfunction was defined as RHI less than 1.35. Spearman correlation coefficient and quantile regression were used to examine associations between RHI and different biomarkers.Results:We included 266 YLPHIV and 69 HIV- participants. At baseline, median (Q1, Q3) age was 12 (11, 13) years and 53% were females. YLPHIV had poorer endothelial function compared with HIV- youth (RHI = 1.36 vs. 1.52, P < 0.01). At baseline and 24 months, YLPHIV had higher markers of monocyte activation (soluble CD14), gut barrier dysfunction (intestinal fatty acid binding protein) and oxidized LDL-cholesterol (P ≤ 0.04) compared with HIV- youth. Among YLPHIV, soluble CD14 remained associated with endothelial dysfunction after adjusting for age, sex, Tanner stage, and antiretroviral therapy duration (β: -0.05, P = 0.01).Conclusion:Despite viral suppression, South African YLPHIV have poor endothelial function and persistent evidence of monocyte activation and gut barrier dysfunction compared with HIV- youth. The long-term clinical significance of gut integrity and monocyte activation needs to be further assessed in YLPHIV.

Original languageEnglish (US)
Pages (from-to)1615-1623
Number of pages9
JournalAIDS
Volume34
Issue number11
DOIs
StatePublished - Sep 1 2020

Funding

Lab support was provided by UH CRC and Case Western CTSC. CTAAC was supported by the Eunice Kennedy Shriver National Institute of Child Health and Human Development (R01HD074051) and the South African Medical Research Council (SAMRC). Additional support includes NICHD K23HD088295 (S.D.-F.), UH CRC and Case CTSC.

Keywords

  • gut integrity
  • inflammation
  • monocyte activation
  • pediatric HIV
  • translocation
  • vascular function

ASJC Scopus subject areas

  • Infectious Diseases
  • Immunology and Allergy
  • Immunology

Fingerprint

Dive into the research topics of 'Monocyte activation and gut barrier dysfunction in South African youth on antiretroviral therapy and their associations with endothelial dysfunction'. Together they form a unique fingerprint.

Cite this