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Heavily Treatment-Experienced (HTE) HIV-Infected Individuals with Vertical Transmission and Detectable Viremia do not Display Increased Peripheral Inflammation Markers: Data from the PRESTIGIO Registry

Background:  Ineffective viral control in Heavily Treatment-Experienced (HTE) fuels inflammation which may be increased in HTE with vertical transmission (VT), given that viral acquisition at birth may alter immune homeostasis. We investigated inflammation in HTE with and without VT, according to viral load (VL) status.

Methods: Matched cohort study including individuals of the Prestigio Registry with resistance to NRTIs, NNRTIs, PIs and INSTIs, with or without VT, VL <50 copies/mL or VL>200 copies/mL. GM-CSF, IFN-α, IFN-γ, IL-2, IL-4, IL-5, IL-6, IL-9, IL-10, IL-12p70, IL-17A, TNF-α (Cytometric Bead Array) and sCD14 (ELISA) were determined. 208 Author Index Late-breaker abstracts Oral abstracts E-posters Poster exhibition ias2023.org Abstract book Propensity score was used to match VT and no-VT for sex, HIV duration, CD4 nadir and VL at plasma sampling. Mann-Whitney test and Spearman’s correlation were calculated.

Results: We evaluated 16 VT and 16 no-VT (Table); in each group, 8/16 had VL<50 copies/mL and 8/16 VL>200 copies/ mL. VT were younger than no-VT (p<0.0001). TV and noTV showed comparable cytokines, with the exception of lower IL-6 in VT (median=0.526 pg/ml, IQR=0-2.85) vs 2.198 pg/ml, IQR=0.94-6.17; p=0.04; 1A) and a trend to lower IL-10 (p=0.08). IL-6 did not differ between VT and no-VT, within viremia strata (1B-C), while a tendency to lower IL-10 was retained in viremic VT (p=0.06; Figure1, D). IL-6 correlated with age (r=0.362, p=0.04; 1E); no other correlations between cytokines and demographic/viro-immunologic parameters were found.

Conclusions: HTE with VT feature comparable inflammation to that of HTE without VT, regardless of VL. The correlation between IL-6 and age suggests that age, rather than mode of transmission and viremia, drives inflammation in treated HIV. 

Dated Mon Jul 24 2023

Authors: V.Bono, V.Spagnuolo, L.Galli, A.di Biagio, M.Augello, R.Rovito, G.Elisa, M.C.Moioli, E.Focà, C.Tincati, A.Castagna, G.Marchetti

Affiliations: Clinic of Infectious Diseases, San Paolo Hospital, University of Milan, Department of Health Sciences, Milan, Italy, Infectious Diseases, IRCCS San Raffaele Scientific Institute, Milan, Italy, Department of Infectious Disease, IRCCS AOU San Martino IST, (DISSAL), University of Genoa, Genoa, Italy, Malattie Infettive Arcispedale S. Maria Nuova-IRCSS, Reggio Emilia, Italy, Department of Infectious Diseases, ASST Grande Ospedale Metropolitano Niguarda, Milan, Italy, Division of Infectious and Tropical Diseases, ASST Spedali Civili Hospital, University of Brescia, Brescia, Italy


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