Objectives: We investigated the significance of microbial translocation measured on average 3 years after HIV seroconversion in driving disease progression in HIV untreated patients with high CD4(+) cell count. VSports手机版.

Design: We included ICONA patients with documented last HIV-negative and first HIV-positive test, at least one plasma sample stored while antiretroviral therapy (ART)-naive and CD4(+) cell count greater than 200 cells/μl. V体育安卓版.

Methods: Microbial translocation [lipopolysaccharide (LPS), sCD14 and EndoCAb] and immune activation (IL-6 and TNF-α) were measured. Correlation between immune activation, microbial translocation, CD4(+) and plasma HIV-RNA was evaluated by linear regression and nonparametric Spearman's rho V体育ios版. The independent predictive value of these markers on time to progression to the combined endpoint of AIDS, death, CD4(+) cell count less than 200 cells/μl or start of antiretroviral therapy (ART) was assessed using survival analysis. .

Results: We analysed 1488 biomarker measures from 379 patients. A median of 3. 1 years after the estimated seroconversion date [interquartile range (IQR) 1. 6-5. 4], median (IQR) markers values were LPS, 110 pg/ml (IQR 75-215), sCD14, 3. 3 μg/ml (2. 2-4. 8), IL-6, 1. 1 pg/ml (0. 6-1. 9) and TNF-α, 2. 4 pg/ml (1. 8-3 VSports最新版本. 4). Two hundred and sixty progression events were recorded over a median of 1. 6 years from the first sample (2% AIDS, 84% ART initiation, 12% CD4(+) cell count less than 200 cells/μl and 2% death). LPS was the only biomarker associated with this primary composite outcome independently of age, HIV-RNA and CD4(+) (relative hazard = 1. 40 per loge higher, 95% confidence interval 1. 18-1. 66, P < 0. 001). .

Conclusion: Circulating LPS in the first years of chronic HIV infection is a strong predictor of disease progression independent of CD4(+) cell count and HIV viraemia and may be considered a candidate biomarker for HIV monitoring and evaluation in clinical trials V体育平台登录. .