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Clin Infect Dis. 2019 Oct 14. pii: ciz1001. doi: 10.1093/cid/ciz1001. [Epub ahead of print]

CMV seropositivity is associated with increased microbial translocation in people living with HIV and uninfected controls.

Author information

1
Chronic Viral Illness Service, McGill University Health Centre, Montreal, QC, Canada.
2
Infectious Diseases and Immunity in Global Health Program, Research Institute, McGill University Health Centre, Montreal, QC, Canada.
3
Department of Microbiology and Immunology, McGill University, Montreal, QC, Canada.
4
Chongqing Public Health Medical Center, Chongqing, Sichuan, China.
5
Centre de Recherche du Centre Hospitalier de l'Université de Montréal, Montréal, QC, Canada.
6
Associates of Cape Cod Inc., Falmouth, MA, United States.
7
Department of Family Medicine, McGill University, Montreal, QC, Canada.
8
Department of Microbiology-Immunology and Infectious Diseases, Laval University, Québec, QC, Canada.
9
Division of Hematology, McGill University Health Centre, Montreal, QC, Canada.

Abstract

BACKGROUND:

Cytomegalovirus (CMV) seropositivity and anti-CMV IgG levels are associated with adverse health outcomes in elderly populations. Among people living with HIV (PLWH) CMV seropositivity has been associated with persistent CD8 T-cell elevation and increased risk of developing non-AIDS comorbidities despite long-term antiretroviral therapy (ART). Herein, we investigated whether CMV seropositivity and elevation of anti-CMV IgG levels were associated with increased epithelial gut damage, microbial translocation, and systemic inflammation.

METHODS:

A total of 150 PLWH (79 ART-naïve and 71 ART-treated) were compared to 26 HIV-uninfected controls (UC). Plasma markers of HIV disease progression, epithelial gut damage, microbial translocation, non-specific B cell activation, anti-CMV and anti-EBV IgG levels, and pro-inflammatory cytokines were measured.

RESULTS:

CMV seropositivity and elevated anti-CMV IgG levels were associated with markers of epithelial gut damage, microbial translocation, and inflammation in PLWH and HIV-uninfected participants. In contrast, total non-specific IgG, IgM, IgA, and anti-EBV IgG levels were not associated with these markers. CMV seropositivity was associated with markers of epithelial gut damage, microbial translocation, and inflammation independently of sociodemographic and behavioural characteristics of the study population.

CONCLUSION:

CMV-seropositive people with and without HIV had increased epithelial gut damage, microbial translocation, and inflammation. Furthermore, anti-CMV IgG levels were independently associated with increased epithelial gut damage and microbial translocation. CMV co-infection may partially explain persistent gut damage, microbial translocation, and inflammation in ART-treated PLWH.

KEYWORDS:

HIV; cytomegalovirus; epithelial gut damage; inflammation; microbial translocation

PMID:
31608409
DOI:
10.1093/cid/ciz1001

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