HIV INFECTION CO-INFECTIONS IMMUNE ACTIVATION AND CHRONIC COMORBIDITIES IN RURAL UGANDA

摘要

In the United States and Europe, suppressed HIV infection is associated with persistent chronic immune activation, systemic inflammation, and an approximately 50% increased risk of atherosclerosis and other pro-inflammatory states. In sub-Saharan Africa, home to over 25 million people with HIV infection, differences in the prevalence of co-infections and lifestyle characteristics are likely to alter the mechanisms of immune activation, as well as the resulting co-morbidities for HIV-infected persons. Soil transmitted helminth and cytomegalovirus infections, which are highly prevalent, induce immune dysregulation and chronic inflammation independently of HIV infection. Similarly, biomass cooking fuel exposure and dietary-induced alterations in the gut microbiome are both correlates of immune activation. We present data from a mixed cohort of treated HIV infected persons and matched HIV-uninfected comparators in rural Uganda to help define the pathophysiology of immune dysregulation and chronic comorbidities, and to discern how region-specific factors impact aging in this population.