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High IL-5 levels possibly contributing to HIV viremia in virologic non-responders at one year after initiation of anti-retroviral therapy

Lack of viral monitoring in HIV infected patients on anti-retroviral therapy in low income countries may result in missing virologic non-responders (VNR) who show immunologic recovery in spite of unsuppressed viral replication. Biomarkers and drug resistance patterns in these discordant patients in...

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Published in:Microbial pathogenesis 2020-06, Vol.143, p.104117-104117, Article 104117
Main Authors: Shete, Ashwini, Kurle, Swarali, Dhayarkar, Sampada, Patil, Ajit, Kulkarni, Smita, Ghate, Manisha, Sangale, Shashikala, Medhe, Uttam, Rajan, Shobini, Verma, Vinita, Gangakhedkar, Raman
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cited_by cdi_FETCH-LOGICAL-c365t-8d9f2a44eda26e109879f9a157116ba8050bc5e435ec2566f482d40901f1ad3b3
cites cdi_FETCH-LOGICAL-c365t-8d9f2a44eda26e109879f9a157116ba8050bc5e435ec2566f482d40901f1ad3b3
container_end_page 104117
container_issue
container_start_page 104117
container_title Microbial pathogenesis
container_volume 143
creator Shete, Ashwini
Kurle, Swarali
Dhayarkar, Sampada
Patil, Ajit
Kulkarni, Smita
Ghate, Manisha
Sangale, Shashikala
Medhe, Uttam
Rajan, Shobini
Verma, Vinita
Gangakhedkar, Raman
description Lack of viral monitoring in HIV infected patients on anti-retroviral therapy in low income countries may result in missing virologic non-responders (VNR) who show immunologic recovery in spite of unsuppressed viral replication. Biomarkers and drug resistance patterns in these discordant patients in comparison to the concordant treatment failure group need to be studied to understand possible risk factors associated with this condition. HIV infected patients on anti-retroviral therapy for one year were enrolled under three categories namely VNRs (n = 25), treatment failures (n = 18) and treatment responders (n = 40). They were assessed for HIV drug resistance by sequencing, plasma cytokines by luminex assay, T cell activation status by flow cytometry and total IgE levels by ELISA. VNR and failure patients had significantly lower median baseline CD4 counts than the responders. VNRs had significantly higher CD4 counts but lower viral load than treatment failures at one year of ART. VNRs had the highest eosinophil counts and the highest IL-5 levels among all the groups. IL-5 levels in them correlated with their viral load values. Frequency of Treg cells was also highest among the VNR group participants. More than 60% of the viremic patients irrespective of their groups harboured multiple HIV drug resistance mutations and mutation pattern did not differ between the groups. Low baseline CD4 counts and presence of multiple drug resistance mutations in the viremic groups highlighted the importance of early ART initiation and viral load monitoring irrespective of presence of immunologic failure. High IL-5 levels in VNR group indicated a need for investigating causal relationship between IL-5 and viral replication to devise therapeutic strategies to control viremia. •Virologic non-responders (VNRs) show immunologic recovery despite virologic failure.•VNRs had highest IL-5 levels, frequency of eosinophils and Tregs among all groups.•IL-5 levels in VNRs correlated with their viral load values.•More than 60% VNRs showed presence of multiple drug resistance mutations.•Higher IL-5 levels possibly explain immunologic recovery despite virologic failure.
doi_str_mv 10.1016/j.micpath.2020.104117
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Biomarkers and drug resistance patterns in these discordant patients in comparison to the concordant treatment failure group need to be studied to understand possible risk factors associated with this condition. HIV infected patients on anti-retroviral therapy for one year were enrolled under three categories namely VNRs (n = 25), treatment failures (n = 18) and treatment responders (n = 40). They were assessed for HIV drug resistance by sequencing, plasma cytokines by luminex assay, T cell activation status by flow cytometry and total IgE levels by ELISA. VNR and failure patients had significantly lower median baseline CD4 counts than the responders. VNRs had significantly higher CD4 counts but lower viral load than treatment failures at one year of ART. VNRs had the highest eosinophil counts and the highest IL-5 levels among all the groups. IL-5 levels in them correlated with their viral load values. Frequency of Treg cells was also highest among the VNR group participants. 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subjects Adolescent
Adult
Anti-HIV Agents - therapeutic use
CD4-CD8 Ratio
Drug Resistance, Viral - genetics
Female
HIV
HIV drug resistance
HIV Infections - drug therapy
HIV Infections - virology
Humans
Interleukin-5
Interleukin-5 - blood
Male
Middle Aged
Treatment Failure
Viremia - blood
Viremia - drug therapy
Virologic non-responders
Young Adult
title High IL-5 levels possibly contributing to HIV viremia in virologic non-responders at one year after initiation of anti-retroviral therapy
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