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PLATELET FUNCTION IN HIV PLUS DENGUE COINFECTION ASSOCIATES WITH REDUCED INFLAMMATION AND MILDER DENGUE ILLNESS
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Fundação Oswaldo Cruz. Instituto Oswaldo Cruz. Laboratório de Imunofarmacologia. Rio de Janeiro, RJ, Brasil / Universidade Federal de Juiz de Fora. Instituto de Ciências Biológicas. Departamento de Bioquímica. Laboratório de Análise de Gliconjugados. Juiz de Fora, MG, Brasil.
Universidade Federal de Juiz de Fora. Instituto de Ciências Biológicas. Departamento de Bioquímica. Laboratório de Análise de Gliconjugados. Juiz de Fora, MG, Brasil.
Fundação Oswaldo Cruz. Instituto Nacional de Infectologia Evandro Chagas. Laboratório de Doenças Febris Agudas. Rio de Janeiro, RJ, Brasil. Rio de Janeiro, RJ. Brasil.
University of Utah. Department of Internal Medicine. Molecular Medicine Program. Salt Lake City, Utah, USA.
Fundação Oswaldo Cruz. Instituto Nacional de Infectologia Evandro Chagas. Laboratório de Medicina Intensiva. Rio de Janeiro, RJ, Brasil / Instituto D’Or de Pesquisa e Ensino. Rio de Janeiro, RJ, Brasil.
Fundação Oswaldo Cruz. Instituto Oswaldo Cruz. Laboratório de Imunofarmacologia. Rio de Janeiro, RJ, Brasil.
Universidade Federal de Juiz de Fora. Instituto de Ciências Biológicas. Departamento de Bioquímica. Laboratório de Análise de Gliconjugados. Juiz de Fora, MG, Brasil.
Fundação Oswaldo Cruz. Instituto Nacional de Infectologia Evandro Chagas. Laboratório de Doenças Febris Agudas. Rio de Janeiro, RJ, Brasil. Rio de Janeiro, RJ. Brasil.
University of Utah. Department of Internal Medicine. Molecular Medicine Program. Salt Lake City, Utah, USA.
Fundação Oswaldo Cruz. Instituto Nacional de Infectologia Evandro Chagas. Laboratório de Medicina Intensiva. Rio de Janeiro, RJ, Brasil / Instituto D’Or de Pesquisa e Ensino. Rio de Janeiro, RJ, Brasil.
Fundação Oswaldo Cruz. Instituto Oswaldo Cruz. Laboratório de Imunofarmacologia. Rio de Janeiro, RJ, Brasil.
Abstract
HIV-infected subjects under virological control still exhibit a persistent proinflammatory state. Thus, chronic HIV infection changes the host homeostasis towards an adapted immune response that may affect the outcome of coinfections. However, little is known about the impact of HIV infection on inflammatory amplification and clinical presentation in dengue. Platelets have been shown to participate in immune response in dengue and HIV. We hypothesized that altered platelet responses in HIV-infected subjects may contribute to altered inflammatory milieu and disease progression in dengue. We prospectively followed a cohort of 84 DENV-infected patients of whom 29 were coinfected with HIV under virological control. We report that dengue and HIV coinfection progress with reduced inflammation and milder disease progression with lower risk of vascular instability. Even though the degree of thrombocytopenia and platelet activation were similar between dengue-infected and HIV plus dengue-coinfected patients, plasma levels of the platelet-derived chemokines RANTES/CCL5 and PF4/CXCL4 were lower in coinfection. Consistently, platelets from coinfected patients presented defective secretion of the stored-chemokines PF4 and RANTES, but not newly synthesized IL-1β, when cultured ex vivo. These data indicate that platelets from HIV-infected subjects release lower levels of chemokines during dengue illness, which may contribute to milder clinical presentation during coinfection.
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