Endotoxin in the pathogenesis of HIV infection

Abstract

The mechanism of immunosuppression progression in HIV infection cannot be reduced only to destruction of CD4⁺ lymphocytes due to the virus replication. Multiple studies have stressed an important role of immune system overactivation in the pathogenesis of the disease. Endotoxin of gram-negative bacteria is considered as one of the factors supporting the immune system activation and manifestations of the systemic inflammatory response of different severity in HIV-infected people. This fact is confirmed by high levels of endotoxin and soluble CD14 receptor as well as by changes in endotoxin-binding antibody titers in a vast majority of patients with HIV infection at different stages of the disease. Excessive amounts of endotoxin release into the blood due to damage of the intestinal wall, which is typical for the course of HIV infection from the disease onset throughout the patient’s life and cannot be completely reversed by antiretroviral therapy (ART). Disorders of the intestinal microbiocenosis, which are also very typical for the HIV infection, can also contribute to the microbial translocation. Further studies in this direction will allow developing methods for pathogenetic therapy, which in combination with ART would increase the effectiveness of therapeutic measures and prolong the life expectancy of patients.