{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,3]],"date-time":"2026-09-03T15:20:48Z","timestamp":1788448848261,"version":"build-2803163510"},"reference-count":37,"publisher":"Wiley","issue":"4","license":[{"start":{"date-parts":[[2015,1,21]],"date-time":"2015-01-21T00:00:00Z","timestamp":1421798400000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["HIV Medicine"],"published-print":{"date-parts":[[2015,4]]},"abstract":"\n Objectives<\/jats:title>\n \n Different immune alterations have been described in\n HIV<\/jats:styled-content>\n \u2010infected patients with visceral leishmaniasis (\n VL<\/jats:styled-content>\n ). We aimed to identify the immunological factors involved in the lack of immunological recovery and\n VL<\/jats:styled-content>\n relapses in\n HIV<\/jats:styled-content>\n \u2010infected patients with\n VL<\/jats:styled-content>\n , by comparison with other\n HIV<\/jats:styled-content>\n \u2010infected patients.\n <\/jats:p>\n <\/jats:sec>\n \n Methods<\/jats:title>\n \n We carried out a cross\u2010sectional study of 55 patients receiving suppressive combination antiretroviral therapy (\n cART<\/jats:styled-content>\n ) for at least 1 year: nine with previous relapsing\n VL<\/jats:styled-content>\n , 20 with an immunodiscordant response (\n IDR<\/jats:styled-content>\n ) to\n cART<\/jats:styled-content>\n (\n CD4<\/jats:styled-content>\n count <\u2009200 cells\/\u03bcL) and no previous\n VL<\/jats:styled-content>\n , and 26 with a concordant response (\n CR<\/jats:styled-content>\n ) to\n cART<\/jats:styled-content>\n (\n CD4<\/jats:styled-content>\n count >\u2009350 cells\/\u03bcL) without\n VL<\/jats:styled-content>\n . Immunosenescence was investigated by analysing\n CD57<\/jats:styled-content>\n +<\/jats:sup>\n CD28<\/jats:styled-content>\n \u2212<\/jats:sup>\n levels, immune activation by analysing\n CD38<\/jats:styled-content>\n +<\/jats:sup>\n HLA\u2010DR<\/jats:styled-content>\n +<\/jats:sup>\n levels, inflammation by analysing interleukin (\n IL<\/jats:styled-content>\n )\u20106 levels, and microbial translocation by analysing lipopolysaccharide (\n LPS<\/jats:styled-content>\n ) and soluble\n CD14<\/jats:styled-content>\n (\n sCD14<\/jats:styled-content>\n ) levels.\n <\/jats:p>\n <\/jats:sec>\n \n Results<\/jats:title>\n \n In\n VL<\/jats:styled-content>\n patients, the median time since\n VL<\/jats:styled-content>\n diagnosis was 42 months, and all patients had had at least one relapse despite suppressive\n cART<\/jats:styled-content>\n for a median time of 43 months. Patients with previously diagnosed\n VL<\/jats:styled-content>\n had a higher\n CD8 T<\/jats:styled-content>\n \u2010cell activation level (\n P<\/jats:italic>\n \u2009<\u20090.001) than those with\n IDR<\/jats:styled-content>\n . Also, levels of\n IL<\/jats:styled-content>\n \u20106,\n LPS<\/jats:styled-content>\n and especially\n sCD14<\/jats:styled-content>\n , associated with bacterial translocation and additional monocyte activation, were significantly increased in patients with previous\n VL<\/jats:styled-content>\n compared with patients with\n IDR<\/jats:styled-content>\n (\n P<\/jats:italic>\n \u2009=\u20090.048,\n P<\/jats:italic>\n \u2009=\u20090.049 and\n P<\/jats:italic>\n \u2009<\u20090.001, respectively). In addition, patients with previous\n VL<\/jats:styled-content>\n had higher levels of\n CD8 T<\/jats:styled-content>\n \u2010cell senescence. Notably, the levels of immune activation and inflammation in patients with previous\n VL<\/jats:styled-content>\n were not related to the time of\n VL<\/jats:styled-content>\n diagnosis, the number of\n VL<\/jats:styled-content>\n relapses, or hepatitis\n C<\/jats:styled-content>\n virus (\n HCV<\/jats:styled-content>\n ) coinfection.\n <\/jats:p>\n <\/jats:sec>\n \n Conclusions<\/jats:title>\n \n Our data demonstrate that\n VL<\/jats:styled-content>\n patients had an even worse immunological status than patients with\n IDR<\/jats:styled-content>\n , which was probably associated with increased microbial translocation and additional monocyte\/macrophage activation. These data explain the observed lack of immunological recovery and the occurrence of\n VL<\/jats:styled-content>\n relapses in\n HIV<\/jats:styled-content>\n \u2010infected patients with previous\n VL<\/jats:styled-content>\n .\n <\/jats:p>\n <\/jats:sec>","DOI":"10.1111\/hiv.12206","type":"journal-article","created":{"date-parts":[[2015,1,21]],"date-time":"2015-01-21T03:19:48Z","timestamp":1421810388000},"page":"240-248","source":"Crossref","is-referenced-by-count":31,"title":["Visceral leishmaniasis as an independent cause of high immune activation,\n T<\/scp>\n \u2010cell senescence, and lack of immune recovery in virologically suppressed\n HIV<\/scp>\n \u20101\u2010coinfected patients"],"prefix":"10.1111","volume":"16","author":[{"given":"JL","family":"Casado","sequence":"first","affiliation":[{"name":"Department of Infectious Diseases Ramon y Cajal Hospital Madrid Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"M","family":"Abad\u2010Fern\u00e1ndez","sequence":"additional","affiliation":[{"name":"Department of Infectious Diseases Ramon y Cajal Hospital Madrid Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"S","family":"Moreno","sequence":"additional","affiliation":[{"name":"Department of Infectious Diseases Ramon y Cajal Hospital Madrid Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"MJ","family":"P\u00e9rez\u2010El\u00edas","sequence":"additional","affiliation":[{"name":"Department of Infectious Diseases Ramon y Cajal Hospital Madrid Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"A","family":"Moreno","sequence":"additional","affiliation":[{"name":"Department of Infectious Diseases Ramon y Cajal Hospital Madrid Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"JI","family":"Bernardino","sequence":"additional","affiliation":[{"name":"Department of Internal Medicine La Paz Hospital Madrid Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"A","family":"Vallejo","sequence":"additional","affiliation":[{"name":"Department of Infectious Diseases Ramon y Cajal Hospital Madrid 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