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Title:	Protease inhibitor monotherapy is associated with a higher level of monocyte activation, bacterial translocation and inflammation
Author:	Torres, Berta; Guardo, Alberto C.; Leal, Lorna; León García, Agathe; Lucero, Constanza; Álvarez Martínez, Míriam; Martínez Yoldi, Miguel Julián; Vila Estapé, Jordi; Martínez Rebollar, María; González Cordón, Ana; Gatell, José M.; Plana Prades, Montserrat; García Alcaide, Felipe
Notes:	Introduction Monotherapy with protease-inhibitors (MPI) may be an alternative to cART for HIV treatment. We assessed the impact of this strategy on immune activation, bacterial translocation and inflammation. Methods We performed a cross-sectional study comparing patients on successful MPI (n=40) with patients on cART (n=20). Activation, senescence, exhaustion and differentiation stage in CD4+ and CD8+ T lymphocyte subsets, markers of monocyte activation, microbial translocation, inflammation, coagulation and low-level viremia were assessed. Results CD4+ or CD8+ T lymphocyte subset parameters were not significantly different between both groups. Conversely, as compared with triple cART, MPI patients showed a higher proportion of activated monocytes (CD14+ CD16−CD163+ cells, p=0.031), soluble markers of monocyte activation (sCD14 p=0.004, sCD163 p=0.002), microbial translocation (lipopolysaccharide (LPS)-binding protein; LBP p=0.07), inflammation (IL-6 p=0.04) and low-level viremia (p=0.035). In a multivariate model, a higher level of CD14+ CD16−CD163+ cells and sCD14, and presence of very low-level viremia were independently associated with MPI. Monocyte activation was independently associated with markers of inflammation (IL-6, p=0.006), microbial translocation (LBP, p=0.01) and low-level viremia (p=0.01). Conclusions Patients on MPI showed a higher level of monocyte activation than patients on standard therapy. Microbial translocation and low-level viremia were associated with the high level of monocyte activation observed in patients on MPI. The long-term clinical consequences of these findings should be assessed.
Subject(s):	-VIH (Virus) -Antiretrovirals -Limfòcits -Translocació (Genètica) -Inhibidors enzimàtics -HIV (Viruses) -Antiretroviral agents -Lymphocytes -Translocation (Genetics) -Enzyme inhibitors
Rights:	cc-by (c) Torres, Berta et al., 2014 http://creativecommons.org/licenses/by/3.0/es
Document type:	Article Article - Published version
Published by:	BioMed Central
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