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de Moraes, Laise; Santos, Luciane Amorim; Arruda, Liã Bárbara; da Silva, Maria da Purificação Pereira; Silva, Márcio de Oliveira; Silva, José Adriano Góes; Ramos, André; Dos Santos, Marcos Bastos; Torres, Felipe Guimarães; Orge, Cibele; Teixeira, Antonio Marcos Dos Santos; Vieira, Thiago Santos; Ramírez, Laura; Soto, Manuel; Grassi, Maria Fernanda Rios; de Siqueira, Isadora Cristina; Costa, Dorcas Lamounier; Costa, Carlos Henrique Nery; Andrade, Bruno de Bezerril; Akrami, Kevan; de Oliveira, Camila Indiani; Boaventura, Viviane Sampaio; Barral-Netto, Manoel; Barral, Aldina; Vandamme, Anne-Mieke; Van Weyenbergh, Johan; Khouri, Ricardo
Frontiers in microbiology, 07/2023, Letnik: 14Journal Article
Visceral leishmaniasis is an opportunistic disease in HIV-1 infected individuals, unrecognized as a determining factor for AIDS diagnosis. The growing geographical overlap of HIV-1 and infections is an emerging challenge worldwide, as co-infection increases morbidity and mortality for both infections. Here, we determined the prevalence of people living with HIV (PWH) with a previous or ongoing infection by and investigated the virological and immunological factors associated with co-infection. We adopted a two-stage cross-sectional cohort (CSC) design (CSC-I, = 5,346 and CSC-II, = 317) of treatment- HIV-1-infected individuals in Bahia, Brazil. In CSC-I, samples collected between 1998 and 2013 were used for serological screening for leishmaniasis by an in-house Enzyme-Linked Immunosorbent Assay (ELISA) with SLA (Soluble Antigen), resulting in a prevalence of previous or ongoing infection of 16.27%. Next, 317 PWH were prospectively recruited from July 2014 to December 2015 with the collection of sociodemographic and clinical data. Serological validation by two different immunoassays confirmed a prevalence of 15.46 and 8.20% by anti-SLA, and anti-HSP70 serology, respectively, whereas 4.73% were double-positive (DP). Stratification of these 317 individuals in DP and double-negative (DN) revealed a significant reduction of CD4 counts and CD4 /CD8 ratios and a tendency of increased viral load in the DP group, as compared to DN. No statistical differences in HIV-1 subtype distribution were observed between the two groups. However, we found a significant increase of CXCL10 ( = 0.0076) and a tendency of increased CXCL9 ( = 0.061) in individuals with DP serology, demonstrating intensified immune activation in this group. These findings were corroborated at the transcriptome level in independent Leishmania- and HIV-1-infected cohorts (Swiss HIV Cohort and Piaui Northeast Brazil Cohort), indicating that CXCL10 transcripts are shared by the IFN-dominated immune activation gene signatures of both pathogens and positively correlated to viral load in untreated PWH. This study demonstrated a high prevalence of PWH with seropositivity in Bahia, Brazil, linked to IFN-mediated immune activation and a significant decrease in CD4 levels. Our results highlight the urgent need to increase awareness and define public health strategies for the management and prevention of HIV-1 and co-infection.
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JCR | SNIP | JCR | SNIP | JCR | SNIP | JCR | SNIP |
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