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Li W, Qing Y, Yu Q, Zhang H, Rang Z, Li S, Cui F. Alterations of the Intestinal Mucosal Barrier and Gut Fungal Microbiome in Asymptomatic HIV-Infected Patients. THE CANADIAN JOURNAL OF INFECTIOUS DISEASES & MEDICAL MICROBIOLOGY = JOURNAL CANADIEN DES MALADIES INFECTIEUSES ET DE LA MICROBIOLOGIE MEDICALE 2024; 2024:6995192. [PMID: 39886072 PMCID: PMC11779998 DOI: 10.1155/cjid/6995192] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 07/09/2024] [Accepted: 11/23/2024] [Indexed: 02/01/2025]
Abstract
Damage to the intestinal mucosal barrier and dysbiosis of the gut microbiota are critical factors in HIV progression, reciprocally influencing each other. Besides bacteria, the fungal microbiota, a significant component of the gut, plays a pivotal role in this dysregulation. This study aims to investigate changes in the gut mucosal barrier and mycobiota during the initial stages of HIV infection, focusing on the involvement of intestinal fungi and their secretions in mucosal damage. Peripheral blood, intestinal mucosa, and fecal samples were collected from 13 asymptomatic HIV-infected individuals at the non-AIDS stage and 13 healthy controls. Assessments included colonoscopy, immune function analysis, and measurement of mucosal damage markers (LPS, I-FABP, and D-LA) and inflammatory cytokines (IL-6 and IL-18). Additionally, Claudin-1 levels in mucosal samples and fungal profiles in fecal samples were evaluated. The study found that colonic abnormalities were significantly more prevalent in the HIV group compared to healthy controls (p < 0.001) and Claudin-1 levels were notably lower in the HIV group (p < 0.001). Candida albicans (p=0.0084), its secretion SAP1 (p=0.023), and the levels of IL-18 (p=0.0016) and IL-6 (p < 0.001) were all significantly higher in the HIV group. CD4+ T-cell counts were positively correlated with Claudin-1 expression (p=0.034, r = 0.417). Candida albicans showed negative correlations with several virulence factors, while other fungi exhibited varied correlations. Additionally, Claudin-1 levels were significantly negatively correlated with Candida albicans (p=0.013, r = -0.668), SAP1 (p=0.027, r = -0.609), IL-18 (p < 0.001, r = -0.922), and IL-6 (p < 0.001, r = -0.920). Overall, these findings suggest that asymptomatic HIV-infected individuals have already exhibited intestinal mucosal damage in the early stage and highlight the critical role of Candida albicans and its secretions in early-stage intestinal mucosal barrier damage.
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Affiliation(s)
- Wenjie Li
- School of Medicine, University of Electronic Science and Technology of China, Chengdu, China
- Institute of Dermatology, Sichuan Academy of Medical Sciences and Sichuan Provincial People's Hospital, Chengdu, China
| | - Yong Qing
- Department of Proctology and Dermatology, Chengdu Anorectal Hospital, Chengdu, China
| | - Qiuyue Yu
- Department of Dermatology, Chengdu Pidu District People's Hospital, Chengdu, China
| | - Hulian Zhang
- Department of Dermatology, Chengdu Xindu District People's Hospital, Chengdu, China
| | - Zhen Rang
- School of Medicine, University of Electronic Science and Technology of China, Chengdu, China
- Institute of Dermatology, Sichuan Academy of Medical Sciences and Sichuan Provincial People's Hospital, Chengdu, China
| | - Shuangli Li
- Department of Dermatology, The Second People's Hospital of Yibin, Yibin, China
| | - Fan Cui
- School of Medicine, University of Electronic Science and Technology of China, Chengdu, China
- Institute of Dermatology, Sichuan Academy of Medical Sciences and Sichuan Provincial People's Hospital, Chengdu, China
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Halichidis S, Aschie M, Cozaru GC, Manea M, Dobrin N, Vlad SE, Matei E, Baltatescu GI, Mitroi AF, Rosu MC, Nitu BF, Resul G, Nicolau AA, Cretu AM, Chisoi A. CMV and HIV Coinfection in Women from a Region in Eastern Europe. J Pers Med 2023; 13:1539. [PMID: 38003854 PMCID: PMC10672055 DOI: 10.3390/jpm13111539] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/23/2023] [Revised: 10/23/2023] [Accepted: 10/24/2023] [Indexed: 11/26/2023] Open
Abstract
(1) Background: Human cytomegalovirus (CMV) infection is one of the most frequent opportunistic infections in immunosuppressed patients. Romania has one of the highest incidences of patients living with human immunodeficiency virus (HIV) which determines an immunosuppressive state. The aim of this study was to establish the prevalence of CMV infection among women living with HIV in Southeastern Romania and also to evaluate and correlate antiretroviral therapy (ART) with CD4 level and CMV disease evolution. (2) Methods: Seventy women living with HIV from Southeastern Romania were screened for CMV infection using antigen quantification. Of these, 50 were included in the study. First, the patients filled out a questionnaire regarding social conditions and other associated diseases. Then, we explored the statistical correlations between the data and HIV status, CD4+ cell counts, viral load, and antiretroviral therapy (ART). (3) Results: Median age of the patients was 33 years. Twenty-nine cases were diagnosed with HIV after sexual life beginning and 21 before. Most of the patients had a CD4 level over 200 cells/µL. ART duration in the CD4 under 200 cells/µL group was a bit longer than that in the CD4 over 200 cells/µL group. Forty-one patients had undetectable viremia. CD4 average value in the lot of patients with undetectable viremia was 704.71 cells/µL and in the lot with detectable viremia was 452.44 cells/µL. Viremia values correlated negatively with CD4 level. A positive correlation between IgG CMV values and ART therapy length was identified. A negative significant correlation between values of IgG CMV and values of CD4 was identified. CD4 value correlated negatively with IgG CMV values and with CMV avidity. (4) Conclusions: IgG CMV values had a weak positive correlation with ART therapy length, and a negative statistically significant correlation with values of CD4. CMV avidity has a negative correlation with CD4 value.
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Affiliation(s)
- Stela Halichidis
- Clinical Hospital of Infectious Diseases, 100 Ferdinand Blvd., 900178 Constanta, Romania; (S.H.); (B.F.N.); (G.R.)
- Faculty of Medicine, Ovidius University of Constanta, 1 Universitatii Street, 900470 Constanta, Romania; (M.A.); (N.D.)
| | - Mariana Aschie
- Faculty of Medicine, Ovidius University of Constanta, 1 Universitatii Street, 900470 Constanta, Romania; (M.A.); (N.D.)
- Sf. Apostol Andrei Emergency County Hospital, 145 Tomis Blvd., 900591 Constanta, Romania; (G.C.C.); (G.I.B.); (A.F.M.); (A.A.N.); (A.M.C.)
- Center for Research and Development of the Morphological and Genetic Studies of Malignant Pathology, Ovidius University of Constanta, 145 Tomis Blvd., 900591 Constanta, Romania; (M.M.); (E.M.); (M.C.R.)
| | - Georgeta Camelia Cozaru
- Sf. Apostol Andrei Emergency County Hospital, 145 Tomis Blvd., 900591 Constanta, Romania; (G.C.C.); (G.I.B.); (A.F.M.); (A.A.N.); (A.M.C.)
- Center for Research and Development of the Morphological and Genetic Studies of Malignant Pathology, Ovidius University of Constanta, 145 Tomis Blvd., 900591 Constanta, Romania; (M.M.); (E.M.); (M.C.R.)
| | - Mihaela Manea
- Center for Research and Development of the Morphological and Genetic Studies of Malignant Pathology, Ovidius University of Constanta, 145 Tomis Blvd., 900591 Constanta, Romania; (M.M.); (E.M.); (M.C.R.)
| | - Nicolae Dobrin
- Faculty of Medicine, Ovidius University of Constanta, 1 Universitatii Street, 900470 Constanta, Romania; (M.A.); (N.D.)
- Center for Research and Development of the Morphological and Genetic Studies of Malignant Pathology, Ovidius University of Constanta, 145 Tomis Blvd., 900591 Constanta, Romania; (M.M.); (E.M.); (M.C.R.)
| | - Sabina E. Vlad
- Center for Research and Development of the Morphological and Genetic Studies of Malignant Pathology, Ovidius University of Constanta, 145 Tomis Blvd., 900591 Constanta, Romania; (M.M.); (E.M.); (M.C.R.)
| | - Elena Matei
- Center for Research and Development of the Morphological and Genetic Studies of Malignant Pathology, Ovidius University of Constanta, 145 Tomis Blvd., 900591 Constanta, Romania; (M.M.); (E.M.); (M.C.R.)
| | - Gabriela Izabela Baltatescu
- Sf. Apostol Andrei Emergency County Hospital, 145 Tomis Blvd., 900591 Constanta, Romania; (G.C.C.); (G.I.B.); (A.F.M.); (A.A.N.); (A.M.C.)
- Center for Research and Development of the Morphological and Genetic Studies of Malignant Pathology, Ovidius University of Constanta, 145 Tomis Blvd., 900591 Constanta, Romania; (M.M.); (E.M.); (M.C.R.)
| | - Anca Florentina Mitroi
- Sf. Apostol Andrei Emergency County Hospital, 145 Tomis Blvd., 900591 Constanta, Romania; (G.C.C.); (G.I.B.); (A.F.M.); (A.A.N.); (A.M.C.)
- Center for Research and Development of the Morphological and Genetic Studies of Malignant Pathology, Ovidius University of Constanta, 145 Tomis Blvd., 900591 Constanta, Romania; (M.M.); (E.M.); (M.C.R.)
| | - Mihai Catalin Rosu
- Center for Research and Development of the Morphological and Genetic Studies of Malignant Pathology, Ovidius University of Constanta, 145 Tomis Blvd., 900591 Constanta, Romania; (M.M.); (E.M.); (M.C.R.)
| | - Bogdan Florentin Nitu
- Clinical Hospital of Infectious Diseases, 100 Ferdinand Blvd., 900178 Constanta, Romania; (S.H.); (B.F.N.); (G.R.)
- SC ProDiagnostic SRL, 30 Farului Street, 90060 Constanta, Romania
| | - Ghiulendan Resul
- Clinical Hospital of Infectious Diseases, 100 Ferdinand Blvd., 900178 Constanta, Romania; (S.H.); (B.F.N.); (G.R.)
- Center for Research and Development of the Morphological and Genetic Studies of Malignant Pathology, Ovidius University of Constanta, 145 Tomis Blvd., 900591 Constanta, Romania; (M.M.); (E.M.); (M.C.R.)
| | - Anca Antonela Nicolau
- Sf. Apostol Andrei Emergency County Hospital, 145 Tomis Blvd., 900591 Constanta, Romania; (G.C.C.); (G.I.B.); (A.F.M.); (A.A.N.); (A.M.C.)
- Center for Research and Development of the Morphological and Genetic Studies of Malignant Pathology, Ovidius University of Constanta, 145 Tomis Blvd., 900591 Constanta, Romania; (M.M.); (E.M.); (M.C.R.)
| | - Ana Maria Cretu
- Sf. Apostol Andrei Emergency County Hospital, 145 Tomis Blvd., 900591 Constanta, Romania; (G.C.C.); (G.I.B.); (A.F.M.); (A.A.N.); (A.M.C.)
- Center for Research and Development of the Morphological and Genetic Studies of Malignant Pathology, Ovidius University of Constanta, 145 Tomis Blvd., 900591 Constanta, Romania; (M.M.); (E.M.); (M.C.R.)
| | - Anca Chisoi
- Sf. Apostol Andrei Emergency County Hospital, 145 Tomis Blvd., 900591 Constanta, Romania; (G.C.C.); (G.I.B.); (A.F.M.); (A.A.N.); (A.M.C.)
- Center for Research and Development of the Morphological and Genetic Studies of Malignant Pathology, Ovidius University of Constanta, 145 Tomis Blvd., 900591 Constanta, Romania; (M.M.); (E.M.); (M.C.R.)
- SC ProDiagnostic SRL, 30 Farului Street, 90060 Constanta, Romania
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Caria J, Leal E, Dias A, Pinheiro H, Póvoas D, Maltez F. A case of central nervous system infection by Candida famata in an immunosuppressed patient with HIV-1 infection. Med Mycol Case Rep 2022; 38:21-24. [PMID: 36203541 PMCID: PMC9530402 DOI: 10.1016/j.mmcr.2022.09.004] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/11/2022] [Revised: 09/19/2022] [Accepted: 09/20/2022] [Indexed: 11/04/2022] Open
Abstract
Invasive fungal infections caused by Candida species are increasingly observed in immunosuppressed patients. Candida albicans is the more often identified species and neurocandidiasis is associated with high mortality rates. Diagnosis and treatment of these infections are frequently challenging. We report a case of central nervous system infection caused by Candida famata in an HIV-1 infected patient. To our best knowledge this is just the second published case of neural infection by this agent.
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