Does Microbial Translocation Drive Progression of Liver Disease?

HIV infection depletes CD4⁺ T cells in gastrointestinal mucosa and disrupts intestinal integrity, thereby increasing microbial translocation. Such translocation has been proposed to play a role in liver disease, perhaps because lipopolysaccharide (LPS) can activate Kupffer cells (hepatic macrophages) and stimulate hepatic stellate cells to produce collagen and fibrosis. To assess whether microbial translocation contributes to liver disease, investigators analyzed levels of multiple biomarkers among 44 women coinfected with HIV and hepatitis C virus (HCV) who had no clinical or laboratory evidence of liver disease at baseline: 21 developed progressive liver disease by year 5; 23 did not. Stored blood samples were analyzed at three evenly spa…