HIV X4 Variants Increase Arachidonate 5-Lipoxygenase in the Pulmonary Microenvironment and are associated with Pulmonary Arterial Hypertension
SCIENTIFIC REPORTS
Authors: Almodovar, Sharilyn; Wade, Brandy E.; Porter, Kristi M.; Smith, Justin M.; Lopez-Astacio, Robert A.; Bijli, Kaiser; Kang, Bum-Yong; Cribbs, Sushma K.; Guidot, David M.; Molehin, Deborah; McNair, Bryan K.; Pumarejo-Gomez, Laura; Hernandez, Jaritza Perez; Salazar, Ethan A.; Martinez, Edgar G.; Huang, Laurence; Kessing, Cari F.; Suarez-Martinez, Edu B.; Pruitt, Kevin; Hsue, Priscilla Y.; Tyor, William R.; Flores, Sonia C.; Sutliff, Roy L.
Abstract
Pulmonary Arterial Hypertension (PAH) is overrepresented in People Living with Human Immunodeficiency Virus (PLWH). HIV protein gp120 plays a key role in the pathogenesis of HIV-PAH. Genetic changes in HIV gp120 determine viral interactions with chemokine receptors; specifically, HIV-X4 viruses interact with CXCR4 while HIV-R5 interact with CCR5 co-receptors. Herein, we leveraged banked samples from patients enrolled in the NIH Lung HIV studies and used bioinformatic analyses to investigate whether signature sequences in HIV-gp120 that predict tropism also predict PAH. Further biological assays were conducted in pulmonary endothelial cells in vitro and in HIV-transgenic rats. We found that significantly more persons living with HIV-PAH harbor HIV-X4 variants. Multiple HIV models showed that recombinant gp120-X4 as well as infectious HIV-X4 remarkably increase arachidonate 5-lipoxygenase (ALOX5) expression. ALOX5 is essential for the production of leukotrienes; we confirmed that leukotriene levels are increased in bronchoalveolar lavage fluid of HIV-infected patients. This is the first report associating HIV-gp120 genotype to a pulmonary disease phenotype, as we uncovered X4 viruses as potential agents in the pathophysiology of HIV-PAH. Altogether, our results allude to the supplementation of antiretroviral therapy with ALOX5 antagonists to rescue patients with HIV-X4 variants from fatal PAH.
Effects of HIV-1 genotype on baseline CD4+cell count and mortality before and after antiretroviral therapy
SCIENTIFIC REPORTS
Authors: Cao, Zhiqiang; Li, Jianjun; Chen, Huanhuan; Song, Chang; Shen, Zhiyong; Zhou, Xinjuan; Lan, Guanghua; Zhu, Qiuying; Liang, Shujia; Xing, Hui; Liao, Lingjie; Feng, Yi; Shao, Yiming; Ruan, Yuhua
Abstract
To assess whether human immunodeficiency virus type 1 (HIV-1) genotype influences baseline CD4+ T lymphocyte (CD4+) cell count and mortality of patients. The study was conducted from 2014 to 2019 in Guangxi, China, and included 2845 newly diagnosed HIV patients. We used a median regression model to compare CD4+ cell counts in patients newly diagnosed with different HIV-1 genotypes, and a Cox regression model to analyze the associations between HIV-1 genotypes and mortality before and after antiretroviral treatment (ART). In newly diagnosed HIV patients, the baseline CD4+ cell counts of patients with CRF01_AE were significantly lower than those of patients with CRF07_BC, CRF08_BC, and other genotypes. Compared with CRF01_AE, patients infected with CRF07_BC (hazard ratio, 0.55; 95% CI 0.36-0.85), CRF08_BC (hazard ratio, 0.67; 95% CI 0.52-0.85), or other genotypes (hazard ratio, 0.52; 95% CI 0.29-0.94) had significantly lower mortality rates before ART. There were no significant associations between different HIV-1 genotypes and mortality after ART. HIV-1 genotype significantly influences baseline CD4+ cell count and mortality before ART in newly diagnosed HIV patients. We find no significant difference in the outcome of death after ART in patients with different HIV-1 genotypes.