Gut epithelial barrier dysfunction in human immunodeficiency virus-hepatitis C virus coinfected patients: Influence on innate and acquired immunity

Even in cases where viral replication has been controlled by antiretroviral therapy for long periods of time, human immunodeficiency virus (HIV)-infected patients have several non-acquired immunodeficiency syndrome (AIDS) related co-morbidities, including liver disease, cardiovascular disease and ne...

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Bibliographic Details
Published in:World journal of gastroenterology : WJG 2016-01, Vol.22 (4), p.1433-1448
Main Authors: Márquez, Mercedes, Fernández Gutiérrez del Álamo, Clotilde, Girón-González, José Antonio
Format: Article
Language:English
Subjects:
Adaptive Immunity
Animals
Bacterial Translocation
Coinfection
Gastrointestinal Microbiome
Hepacivirus - immunology
Hepatitis C - diagnosis
Hepatitis C - immunology
Hepatitis C - microbiology
Hepatitis C - virology
HIV - immunology
HIV Infections - diagnosis
HIV Infections - immunology
HIV Infections - microbiology
HIV Infections - virology
Host-Pathogen Interactions
Humans
Immunity, Innate
Immunity, Mucosal
Intestinal Mucosa - immunology
Intestinal Mucosa - microbiology
Intestinal Mucosa - virology
Permeability
Prognosis
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Summary:Even in cases where viral replication has been controlled by antiretroviral therapy for long periods of time, human immunodeficiency virus (HIV)-infected patients have several non-acquired immunodeficiency syndrome (AIDS) related co-morbidities, including liver disease, cardiovascular disease and neurocognitive decline, which have a clear impact on survival. It has been considered that persistent innate and acquired immune activation contributes to the pathogenesis of these non-AIDS related diseases. Immune activation has been related with several conditions, remarkably with the bacterial translocation related with the intestinal barrier damage by the HIV or by hepatitis C virus (HCV)-related liver cirrhosis. Consequently, increased morbidity and mortality must be expected in HIV-HCV coinfected patients. Disrupted gut barrier lead to an increased passage of microbial products and to an activation of the mucosal immune system and secretion of inflammatory mediators, which in turn might increase barrier dysfunction. In the present review, the intestinal barrier structure, measures of intestinal barrier dysfunction and the modifications of them in HIV monoinfection and in HIV-HCV coinfection will be considered. Both pathogenesis and the consequences for the progression of liver disease secondary to gut microbial fragment leakage and immune activation will be assessed.
ISSN:1007-9327
2219-2840
DOI:10.3748/WJG.V22.I4.1433