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Belly Fat (lipodystophy) May be Caused by Metabolic Abnormalities: immune activation/inflammation/senescence
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Reported by Jules Levin
CROI 2016 Feb 22-24 Boston
"Metabolic Abnormalities - immune activation/semescence/inflammation-...Underlie Visceral Adiposity......SIV skews activation in adipose tissue (belly) towards inflammatory M1 profile " and "HIV increases glucose metabolic activity in monocytes and is correlated with inflammation".....oxidative stress can damages mitochondrial DNA....preliminary data finds mitochondrial dysfunction in frail elderly HIV+ with viral suppression....what causes persistent immune activation in HIV+ with virology suppression? "microbial translocation, HIV persistence and coinfections all may play a role"....studies have shown clear correlation between markers of t-cell activation & HIV persistence in blood and in tissues as well (lymph node, gut)....microbial translocation caused by increased gut permeability in HIV+ may be the major cause of persistent activation & inflammation which eventually can lead to metabolic abnormalities, activation & inflammation and onto end organ disease in patients with viral suppression....the gut micro biome (differentially abundant micro-organisms) in HIV+ is associated with increased markers of microbial translocation & markers of systemic inflammation (CRP, TNF, sCD14) & gut micro biome is linked via inflammatory processes to visceral adiposity"
"Increase in monocyte activation occurs within 4 & 12 years earlier in HIV+ vs HIV-negs, 12 years earlier for those not on ART & 4 years earlier for those with virologic suppression."
"HIV+ and people with normal aging experience similar changes in immune activation, immune senescence, reduced tolemerase length & inflammation" AND these metabolic changes are likely to underlie increased risk for cardiometabolic disease, type 2 diabetes, visceral adiposity, osteoporosis & malignancies"
Immunopathogenesis of Metabolic Complications in Treated HIV Infection
Suzanne M. Crowe
Burnet Institute, Melbourne, Australia
WEBCAST:http://www.croiwebcasts.org/console/player/29682?mediaType=audio&
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