Gut Innate Immune System (InImS) Biomarker Changes Are Seen in Treated HIV Patients as Compared to Non-HIV Controls

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Introduction: Early HIV replication in the gastrointestinal tract plays an important role in HIV pathogenesis. We have followed the onset of the acquired immune deficiency disease (AIDS) pandemic and human immunodeficiency virus (HIV) infection from its recognition in the US. Patients and Methods: We followed 34 adult HIV positive Veterans on cART comparing colon Innate Immune System (InImS) expression of a Paneth cell product (p87; the denominator) and blood ferritin (the numerator) to derive the FERAD ratio, and p87 expression by immunohistochemistry available in some of our HIV patients and compare the expression to 2252 without HIV. Stool and colonoscopically obtained tissue specimens were run in a p87 ELISA and immunohistochemistry for both fixed and native antigens, using the Adnab-9 antibody. Results: There were no significant differences in demographics aside from lower BMI in HIV patients (24.93 ± 6.30 vs. 28.0 ± 6.13 kg/m2) p < 0.0001. Native p87 antigen was elevated in HIV patients compared to controls in the ascending, transverse, and descending colon (0.794 ± 0.890 vs. 0.170 ± 0.201 respectively; p < 0.000004; 1.062 ± 0.730 vs. 0.202 ± 0.377 respectively; p < 0.000003; and 0.611 ± 0.182 vs. 0.174 ± 0.251 respectively; p < 0.0009), respectively; and Helicobacter pylori (H. pylori) detection was higher in HIV patients (84.6% vs. 36%; p < 0.0002). We also ran these assays in cancer patients for comparison. Conclusions: Colonic inflammation as expressed by p87, a Paneth cell product, is significantly elevated in HIV patients and likely represents continued HIV activity leading to inflammation.

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