HIV disease: fallout from a mucosal catastrophe?

By J. Brenchley, D. Price, Daniel C. Douek. Nature Immunology, 2006

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Microbial translocation is a cause of systemic immune activation in chronic HIV infection (2006, background): “However, the underlying causes of immune activation have remained elusiv”
Plasma levels of soluble CD14 independently predict mortality in HIV infection. (2011, background): “Rapid depletion of CD4 T cells from the intestine [9, 10], decreased luminal immunoglobulin (Ig) A concentration [11], massive enterocyte apoptosis, and breakdown of enterocyte tight junctions [12, 13] result in a compromised intestinal mucosal barrier.”
Plasma Levels of Bacterial DNA Correlate with Immune Activation and the Magnitude of Immune Restoration in Persons with Antiretroviral-Treated HIV Infection (2009, unknown): “Our data [7, 18], as well as emerging data from other investigators [25], indicate that bacterial products (LPS and bacterial DNA) are often circulating in the plasma of HIV-infected patients.”
Exposure to HIV-1 Directly Impairs Mucosal Epithelial Barrier Integrity Allowing Microbial Translocation (2010, background): “Studies that have demonstrated immune activation propose this to be the main driving force for progressive immune failure leading to the immunodeficiency stage [22–24].”
Immune activation and inflammation in HIV‐1 infection: causes and consequences (2008, background): “Compromising its integrity may therefore results in microbial translocation from the gut to the systemic immune system [43].”