LEVELS OF PLASMA SOLUBLE CD14 IN HIV-INFECTED OPIATE USERS

Abstract

Chronic immune activation is one of the main causes of HIV disease progression. Bacterial components passed to the bloodstream from the gut as a result of microbial translocation, are known to induce immune activation. Component of Gram-negative bacteria’s cell walls, the lipopolysaccharide (LPS), is considered to be the major marker of microbial translocation. Through the activation of myeloid cells (predominantly monocytes) LPS causes the secretion of soluble CD14, thus making it a marker of LPS bioactivity. Besides sCD14 was shown to correlate with immune status in HIVinfected patients and to be an independent predictor of disease progression. Hypothesis: opiates increase microbial translocation from the gut in HIV-infected patients that is manifested by a higher concentration of sCD14 in plasma. Aim: to estimate the influence of opiate use on the level of sCD14 in plasma of HIV-infected patients. Materials and methods. Longitudinal study of 351 HIV positive individuals. Concentration of sCD14, was evaluated at 3 time points: baseline, after 12 and 24 months. Following groups were studied: 1) current opiate users – opiate use within past 30 days; 2) opiate users, who denied consumption of opiates within past 30 days; 3) people claiming to never have used opiates. Results. In dynamic assessment sCD14 mean was significantly higher in current opiate users (2222,46±39,02 ng/ml) against patients who denied opiates within past 30 days (1930±597 ng/ml) and those, claiming to never have used opiates (1915±577 ng/ml) (p<0,001). Conclusion. Opiate use in the course of HIV disease leads to increase in LPS induced monocyte activation which therefore signifies more intensive microbial translocation.