Sexually transmitted infections and immune activation among HIV-infected but virally suppressed youth on antiretroviral therapy.

TitleSexually transmitted infections and immune activation among HIV-infected but virally suppressed youth on antiretroviral therapy.
Publication TypePublication
Year of Publication2018
AuthorsMullins TLKowalczy, Li SX, Bethel J, Goodenow MM, Hudey S, Sleasman JW
Corporate AuthorsAdolescent Medicine Trials Network for HIV AIDS Interventions
JournalJ Clin Virol
Volume102
Pagination7-11
Date Published2018 05
ISSN1873-5967
KeywordsAdolescent, Antiretroviral Therapy, Highly Active, CD4 Lymphocyte Count, CD4-Positive T-Lymphocytes, Female, HIV Infections, Humans, Lymphocyte Activation, Male, Sexually Transmitted Diseases, T-Lymphocyte Subsets, United States, Young Adult
Abstract

<p><b>BACKGROUND: </b>Human immunodeficiency virus (HIV) infection is associated with chronic immune activation, and concurrent sexually transmitted infections (STIs) may increase immune activation.</p><p><b>OBJECTIVES: </b>Because HIV-infected youth are at high risk of STIs and little is known about the impact of STIs on immune activation in HIV-infected youth, we conducted an exploratory study examining the association between STIs and systemic inflammation and immune activation among HIV-infected adolescents.</p><p><b>STUDY DESIGN: </b>Forty-nine behaviorally infected U.S. youth ages 18-24 years with baseline CD4 T-cells >350 who maintained viral suppression on therapy by week 48 were included. Evaluation for STIs (herpes simplex virus [HSV], Chlamydia trachomatis, syphilis, Neisseria gonorrhoeae) was conducted as standard of care and reported on case report forms. Measures of T-cell subsets, systemic immune activation, and soluble factors were examined at week 48 for differences between participants with an STI diagnosis during the 48 weeks compared to those without an STI.</p><p><b>RESULTS: </b>Forty-three participants (88%) were male; 57% had baseline CD4+ T-cell counts >500 cells/mm. Eighteen youth were reported to have ≥1 STI. At week 48, participants with STIs demonstrated lower CD4 T-cell counts (any STI vs. no STI, p = 0.024; HSV vs. no STI, p = 0.022) and evidence of increased systemic immune activation, including higher CD57 intensity, higher HLA-DR intensity, and lower CD28 percentage, when compared to those without STIs. There were no differences in soluble factors between STI groups.</p><p><b>CONCLUSIONS: </b>Results indicate novel activation of CD4 T-cells among HIV-infected youth who have STIs other than HSV, which may contribute to disease progression.</p>

DOI10.1016/j.jcv.2018.02.001
Alternate JournalJ. Clin. Virol.
PubMed ID29454196
PubMed Central IDPMC5889960
Grant ListU01 HD040533 / HD / NICHD NIH HHS / United States
U01 HD040474 / HD / NICHD NIH HHS / United States
UL1 RR025780 / RR / NCRR NIH HHS / United States
U01 AI068632 / AI / NIAID NIH HHS / United States
UL1 RR024131 / RR / NCRR NIH HHS / United States
R01 DA031017 / DA / NIDA NIH HHS / United States
M01 RR010284 / RR / NCRR NIH HHS / United States
K23 HD072807 / HD / NICHD NIH HHS / United States
UL1 RR024134 / RR / NCRR NIH HHS / United States
M01 RR020359 / RR / NCRR NIH HHS / United States