Immune Activation, Inflammation, and Non-AIDS Co-Morbidities in HIV-Infected Patients under Long-Term ART
Sonia Zicari,
Libera Sessa,
Nicola Cotugno,
Alessandra Ruggiero,
Elena Morrocchi,
Carlo Concato,
Salvatore Rocca,
Paola Zangari,
Emma C. Manno,
Paolo Palma
Affiliations
Sonia Zicari
Research Unit in Congenital and Perinatal Infections, Academic Department of Pediatrics (DPUO), Division of Immunology and Infectious Diseases, Bambino Gesù Children’s Hospital, 00165 Rome, Italy
Libera Sessa
Department of Systems Medicine, University of Rome Tor Vergata, 00133 Rome, Italy
Nicola Cotugno
Research Unit in Congenital and Perinatal Infections, Academic Department of Pediatrics (DPUO), Division of Immunology and Infectious Diseases, Bambino Gesù Children’s Hospital, 00165 Rome, Italy
Alessandra Ruggiero
Research Unit in Congenital and Perinatal Infections, Academic Department of Pediatrics (DPUO), Division of Immunology and Infectious Diseases, Bambino Gesù Children’s Hospital, 00165 Rome, Italy
Elena Morrocchi
Department of Systems Medicine, University of Rome Tor Vergata, 00133 Rome, Italy
Carlo Concato
Department of Laboratories, Division of Virology, Bambino Gesù Children’s Hospital, 00165 Rome, Italy
Salvatore Rocca
Research Unit in Congenital and Perinatal Infections, Academic Department of Pediatrics (DPUO), Division of Immunology and Infectious Diseases, Bambino Gesù Children’s Hospital, 00165 Rome, Italy
Paola Zangari
Research Unit in Congenital and Perinatal Infections, Academic Department of Pediatrics (DPUO), Division of Immunology and Infectious Diseases, Bambino Gesù Children’s Hospital, 00165 Rome, Italy
Emma C. Manno
Research Unit in Congenital and Perinatal Infections, Academic Department of Pediatrics (DPUO), Division of Immunology and Infectious Diseases, Bambino Gesù Children’s Hospital, 00165 Rome, Italy
Paolo Palma
Research Unit in Congenital and Perinatal Infections, Academic Department of Pediatrics (DPUO), Division of Immunology and Infectious Diseases, Bambino Gesù Children’s Hospital, 00165 Rome, Italy
Despite effective antiretroviral therapy (ART), people living with HIV (PLWH) still present persistent chronic immune activation and inflammation. This condition is the result of several factors including thymic dysfunction, persistent antigen stimulation due to low residual viremia, microbial translocation and dysbiosis, caused by the disruption of the gut mucosa, co-infections, and cumulative ART toxicity. All of these factors can create a vicious cycle that does not allow the full control of immune activation and inflammation, leading to an increased risk of developing non-AIDS co-morbidities such as metabolic syndrome and cardiovascular diseases. This review aims to provide an overview of the most recent data about HIV-associated inflammation and chronic immune exhaustion in PLWH under effective ART. Furthermore, we discuss new therapy approaches that are currently being tested to reduce the risk of developing inflammation, ART toxicity, and non-AIDS co-morbidities.
