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Biomarkers of Disease Progression Appear to Differ in Sub-Saharan Population


Study examines immune activation and inflammation in Ugandan cohort

Immune activation and inflammation help predict HIV disease progression and AIDS mortality in industrialized countries. These associations are different for a Sub-Saharan African population, according to an article published this week in the Journal of Acquired Immune Deficiency Syndromes.

The study assessed biomarkers of inflammation, microbial translocation, and cellular activation in a cohort of Ugandan HIV-1 seroconverters to understand their relationship to disease progression. The authors found most biomarkers elevated in HIV positive individuals compared to community-matched HIV-uninfected individuals. Several analytes, including CRP, neopterin, and IFABP were not elevated in HIV-1 infection, which contrasts with previous findings in Western cohorts.

“These data suggest differential relationships among biomarkers of intestinal barrier integrity and innate immune activation between developed countries and Sub-Saharan Africa,” said Dr. Michael Eller, an immunologist with the Military HIV Research Program and co-author of the publication.

In the Ugandan cohort, higher T-cell activation and IL-6 were associated with faster disease progression, whereas IFABP levels, indicative of enterocyte turnover, was elevated in slow progressors compared to fast progressors. 

According to the authors, given the apparent differences between Western and Sub-Saharan African populations, additional studies are required to assess the basis of HIV-1 disease in Sub-Saharan Africa as well as determine major determinants driving immune activation and inflammation in this population.