During the first 3 weeks of HIV infection the replication of the virus peaks in peripheral blood. It is still not clear how the small amount of transmitted founder virus is able to set up this large and heterogeneous systemic infection. The authors found that during the hyperacute pre-peak phase of SIV infection in macaques, high levels of microbial DNA transiently translocate into the peripheral blood. This translocation is accompanied by a sustained reduction in lipopolysaccharide (LPS)-specific antibody titres, increased intestinal permeability, increased abundance of CD4+/CCR5+ T cell targets of virus replication and T cell activation. The authors were interested in whether this increased gastrointestinal permeability causing microbial translocation is able to amplify the HIV viraemia. They treated two SIV-infected macaque elite controllers with a short-course of dextran sulfate sodium (DSS) which stimulates a transient increase in microbial translocation and found that this does lead to a prolonged recrudescent viraemia. Therefore translocating microbes may act as amplifiers of HIV replication that undermines the host’s capacity to contain infections.
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