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Evaluation of HIV-DNA and inflammatory markers in HIV-infected individuals with different viral load patterns.

Evaluation of HIV-DNA and inflammatory markers in HIV-infected individuals with different viral load patterns.
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Falasca F, Di Carlo D, De Vito C, Bon I, d'Ettorre G, Fantauzzi A, Mezzaroma I, Fimiani C, Re MC, Vullo V, Antonelli G, Turriziani O,


Falasca F, Di Carlo D, De Vito C, Bon I, d'Ettorre G, Fantauzzi A, Mezzaroma I, Fimiani C, Re MC, Vullo V, Antonelli G, Turriziani O, (click to view)

Falasca F, Di Carlo D, De Vito C, Bon I, d'Ettorre G, Fantauzzi A, Mezzaroma I, Fimiani C, Re MC, Vullo V, Antonelli G, Turriziani O,

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BMC infectious diseases 2017 08 2217(1) 581 doi 10.1186/s12879-017-2676-2

Abstract
BACKGROUND
Persistent residual viremia (RV) and low grade inflammation and immune activation have been associated with non-AIDS defining events. The impact of persistent RV and HIV-DNA load on immune activation/inflammation remains unclear. The purpose of this study was to gain new insights into the relation between viremia, markers of inflammation and HIV-DNA levels.

METHODS
Three hundred and twenty-one HIV-infected patients were studied. A retrospective analysis of viremia values, prospectively collected for 48 months, was performed. Patients were separated into three groups: 113 TND (Target Not Detected, patients with sustained undetectable viremia); 113 RV (Residual Viremia, patients who had at least three detectable viral load (VL) values <37 copies/ml); 95 LLV (Low Level Viremia, patients with at least two VL values >37 but <200 copies/ml). HIV-DNA, TNF-α, IL-6 and sCD14 were analyzed. RESULTS
HIV-DNA, sCD14 and TNF-α were significantly lower in the TND group than in the RV and LLV groups. In addition, RV patients showed lower levels of HIV-DNA and sCD14 than LLV individuals. HIV-DNA load was not related to markers of inflammation. The ordinal logistic analysis showed that two independent variables were significantly associated with VL pattern: sCD14, HIV-DNA. In addition NRTIs plus NNRTIs and NRTIs plus PIs were negatively associated to VL pattern compared to INI-containing regimen.

CONCLUSIONS
Persistent undetectable viremia was associated with lower levels of inflammatory markers and HIV-DNA. However, the lack of normalization of these biomarkers in the TND group and the fact that HIV-DNA load was not associated with inflammation strongly suggest that other mechanisms play a major role in maintaining inflammation over time.

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