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Comparison of Immune Activation and Gut Barrier Dysfunction Between Long COVID and HIV Infection

delete2026-04-01
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PRE
AI
K
Koberssy, Ziad
J
Joviane Daher
J
Jared Durieux
O
Ornina Atieh
B
Baissary, Jhony
A
Abboud, Marc
A
Ailstock, Kate
C
Cummings, Morgan
N
Nicholas Funderburg
G
Grace A. McComsey *
DOI:10.1093/infdis/jiag146delete
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Abstract

Abstract

En 中文
Background Human immunodeficiency virus (HIV) infection is characterized by persistent immune dysregulation and inflammation, with emerging evidence suggesting overlapping pathophysiological mechanisms with long coronavirus disease (COVID). Biomarkers of systemic inflammation and gut integrity may provide insight into shared and distinct pathways underlying these conditions. The status of the anti-inflammatory vitamin K may play a role in sustained inflammation in these conditions. Methods This cross-sectional study enrolled participants belonging to 1 of 3 groups: individuals with long COVID without HIV (n = 108); participants with HIV (PWH) virologically suppressed with no previous COVID-19 infection (n = 256); and controls without long COVID or HIV (n = 193). Plasma samples were analyzed for inflammatory, gut integrity biomarkers, and dephosphorylated-uncarboxylated matrix Gla protein (dp-ucMGP) as an established marker of vitamin K status. Associations were assessed using multivariable linear and logistic regression models adjusted for demographic, metabolic, and lifestyle covariates. Results In total, 557 participants were included. Long COVID was independently associated with elevated oxidized low-density lipoprotein (beta = .39 vs HIV, beta = .54 vs controls; P < .001 for both). PWH had higher odds of worse vitamin K status (odds ratio, 1.5; 95% CI, 1.02-2.2; P = .04). Independent of long COVID or HIV status, worse vitamin K status was strongly associated with higher levels of inflammatory markers. Conclusions Long COVID and HIV share chronic immune dysregulation features but demonstrate distinct inflammatory profiles. These findings highlight the importance of large longitudinal studies to delineate shared versus unique inflammatory pathways to guide potential long COVID therapeutic strategies.
Keywords:
long COVID
human immunodeficiency virus (HIV)
dephosphorylated-uncarboxylated matrix Gla protein (dp-ucMGP)
vitamin K
oxidized LDL

Journal

Journal of Infectious Diseases cover
Journal of Infectious Diseases
IF:
4.5
Papers:
1.7W
Citations:
4.3W

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U
University System of Ohio
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case western reserve university
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2.6K
Papers: 1.3K
Citations: 0
University Hospitals of Cleveland cover
University Hospitals of Cleveland
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Citations: 4.0K
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