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Clin Infect Dis. 2015 Nov 15;61(10):1615-23. doi: 10.1093/cid/civ577. Epub 2015 Jul 20.

Helicobacter pylori Coinfection Is Associated With Decreased Markers of Immune Activation in ART-Naive HIV-Positive and in HIV-Negative Individuals in Ghana.

Author information

1
Clinical Research Unit, Bernhard Nocht Institute for Tropical Medicine, Hamburg, Germany.
2
Kwame Nkrumah University of Science and Technology Komfo Anokye Teaching Hospital, Kumasi, Ghana.
3
Komfo Anokye Teaching Hospital, Kumasi, Ghana.
4
Clinic of Gastroenterology, Hepatology and Infectious Diseases, Heinrich Heine University Düsseldorf.
5
Division of Infectious Diseases and Tropical Medicine, Medical Center of the University of Munich (Ludwig Maximilian University [LMU]) German Centre for Infection Research (partner site), Munich.
6
Institute of Virology, University of Bonn Medical Centre.
7
Clinical Research Unit, Bernhard Nocht Institute for Tropical Medicine, Hamburg, Germany Institute for Interdisciplinary Medicine, Asklepios Klinik St Georg, Hamburg, Germany.
8
Clinical Research Unit, Bernhard Nocht Institute for Tropical Medicine, Hamburg, Germany Clinic of Gastroenterology, Hepatology and Infectious Diseases, Heinrich Heine University Düsseldorf.

Abstract

BACKGROUND:

Helicobacter pylori coinfection in human immunodeficiency virus (HIV) patients has been associated with higher CD4+ cell counts and lower HIV-1 viral loads, with the underlying mechanisms being unknown. The objective of this study was to investigate the impact of H. pylori infection on markers of T-cell activation in HIV-positive and HIV-negative individuals.

METHODS:

In a cross-sectional, observational study, HIV patients (n = 457) and HIV-negative blood donors (n = 79) presenting to an HIV clinic in Ghana were enrolled. Data on clinical and sociodemographic parameters, CD4+/CD8+ T-cell counts, and HIV-1 viral load were recorded. Helicobacter pylori status was tested using a stool antigen test. Cell surface and intracellular markers related to T-cell immune activation and turnover were quantified by flow cytometry and compared according to HIV and H. pylori status.

RESULTS:

Helicobacter pylori infection was associated with decreased markers of CD4+ T-cell activation (HLA-DR+CD38+CD4+; 22.55% vs 32.70%; P = .002), cell proliferation (Ki67; 15.10% vs 26.80%; P = .016), and immune exhaustion (PD-1; 32.45% vs 40.00%; P = .005) in 243 antiretroviral therapy (ART)-naive patients, but not in 214 patients on ART. In HIV-negative individuals, H. pylori infection was associated with decreased frequencies of activated CD4+ and CD8+ T cells (6.31% vs 10.40%; P = .014 and 18.70% vs 34.85%, P = .006, respectively).

CONCLUSIONS:

Our findings suggest that H. pylori coinfection effectuates a systemic immune modulatory effect with decreased T-cell activation in HIV-positive, ART-naive patients but also in HIV-negative individuals. This finding might, in part, explain the observed association of H. pylori infection with favorable parameters of HIV disease progression.

CLINICAL TRIALS REGISTRATION:

Clinicaltrials.gov NCT01897909.

KEYWORDS:

HIV/AIDS; Helicobacter pylori; immune activation; sub-Saharan Africa

PMID:
26195015
DOI:
10.1093/cid/civ577
[Indexed for MEDLINE]

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