Rifaximin has a marginal impact on microbial translocation, T-cell activation and inflammation in HIV-positive immune non-responders to antiretroviral therapy - ACTG A5286.

TitleRifaximin has a marginal impact on microbial translocation, T-cell activation and inflammation in HIV-positive immune non-responders to antiretroviral therapy - ACTG A5286.
Publication TypeJournal Article
Year of Publication2015
AuthorsTenorio AR, Chan ES, Bosch RJ, Macatangay BJC, Read SW, Yesmin S, Taiwo B, Margolis DM, Jacobson JM, Landay AL, Wilson CC
Corporate AuthorsA5286 Team
JournalJ Infect Dis
Volume211
Issue5
Pagination780-90
Date Published2015 Mar 1
ISSN1537-6613
KeywordsAdolescent, Adult, Aged, Anti-Bacterial Agents, Antigens, CD14, Antiretroviral Therapy, Highly Active, Bacterial Translocation, CD8-Positive T-Lymphocytes, Female, HIV Infections, Humans, Inflammation, Lipopolysaccharides, Lymphocyte Activation, Male, Middle Aged, Rifamycins, Treatment Outcome, Young Adult
Abstract

BACKGROUND: Rifaximin, a nonabsorbable antibiotic that decreases lipopolysaccharide (LPS) in cirrhotics, may decrease the elevated levels of microbial translocation, T-cell activation and inflammation in human immunodeficiency virus (HIV)-positive immune nonresponders to antiretroviral therapy (ART).

METHODS: HIV-positive adults receiving ART for ≥96 weeks with undetectable viremia for ≥48 weeks and CD4(+) T-cell counts <350 cells/mm(3) were randomized 2:1 to rifaximin versus no study treatment for 4 weeks. T-cell activation, LPS, and soluble CD14 were measured at baseline and at weeks 2, 4, and 8. Wilcoxon rank sum tests compared changes between arms.

RESULTS: Compared with no study treatment (n = 22), rifaximin (n = 43) use was associated with a significant difference between study arms in the change from baseline to week 4 for CD8(+)T-cell activation (median change, 0.0% with rifaximin vs +0.6% with no treatment; P = .03). This difference was driven by an increase in the no-study-treatment arm because there was no significant change within the rifaximin arm. Similarly, although there were significant differences between study arms in change from baseline to week 2 for LPS and soluble CD14, there were no significant changes within the rifaximin arm.

CONCLUSIONS: In immune nonresponders to ART, rifaximin minimally affected microbial translocation and CD8(+)T-cell activation. Trial registration number. NCT01466595.

DOI10.1093/infdis/jiu515
Alternate JournalJ. Infect. Dis.
PubMed ID25214516
PubMed Central IDPMC4334803
Grant ListA1025439 / / PHS HHS / United States
AI045008 / AI / NIAID NIH HHS / United States
AI068636 / AI / NIAID NIH HHS / United States
AI069412 / AI / NIAID NIH HHS / United States
AI069415 / AI / NIAID NIH HHS / United States
AI069418 / AI / NIAID NIH HHS / United States
AI069419 / AI / NIAID NIH HHS / United States
AI069423 / AI / NIAID NIH HHS / United States
AI069424 / AI / NIAID NIH HHS / United States
AI069432 / AI / NIAID NIH HHS / United States
AI069439 / AI / NIAID NIH HHS / United States
AI069447 / AI / NIAID NIH HHS / United States
AI069452 / AI / NIAID NIH HHS / United States
AI069470 / AI / NIAID NIH HHS / United States
AI069471 / AI / NIAID NIH HHS / United States
AI069477 / AI / NIAID NIH HHS / United States
AI069481 / AI / NIAID NIH HHS / United States
AI069494 / AI / NIAID NIH HHS / United States
AI069501 / AI / NIAID NIH HHS / United States
AI069502 / AI / NIAID NIH HHS / United States
AI069503 / AI / NIAID NIH HHS / United States
AI069511-08 / AI / NIAID NIH HHS / United States
AI069532 / AI / NIAID NIH HHS / United States
AI069534 / AI / NIAID NIH HHS / United States
AI069556 / AI / NIAID NIH HHS / United States
AI073961 / AI / NIAID NIH HHS / United States
AI50410 / AI / NIAID NIH HHS / United States
AL050404 / / PHS HHS / United States
RR024160 / RR / NCRR NIH HHS / United States
TR000439 / TR / NCATS NIH HHS / United States
TR001070 / TR / NCATS NIH HHS / United States
TR001082 / TR / NCATS NIH HHS / United States
TR001111 / TR / NCATS NIH HHS / United States
UL1 TR000042 / TR / NCATS NIH HHS / United States
UL1 TR000439 / TR / NCATS NIH HHS / United States
UL1 TR000457 / TR / NCATS NIH HHS / United States
UL1 TR001070 / TR / NCATS NIH HHS / United States
UL1 TR001082 / TR / NCATS NIH HHS / United States
UM1 AI068634 / AI / NIAID NIH HHS / United States
UM1 AI068636 / AI / NIAID NIH HHS / United States
UM1 AI069424 / AI / NIAID NIH HHS / United States
UM1 AI069481 / AI / NIAID NIH HHS / United States
UM1 AI069511 / AI / NIAID NIH HHS / United States
UM1 AI106701 / AI / NIAID NIH HHS / United States