HIV infection is associated with reduced serum alpha-1-antitrypsin concentrations

Bryan, Courtney L.; Scott Beard, K.; Pott, Gregory B.; Rahkola, Jeremy; Gardner, Edward M.; Jano, Edward N.; Shapiro, Leland
December 2010
Clinical & Investigative Medicine;Dec2010, Vol. 33 Issue 6, pE384
Academic Journal
Purpose: Several observations suggest the presence of HIV-suppressive factors in the "fluid phase of blood. Alpha-1-antitrypsin (AAT), the most abundant serine protease inhibitor in the circulation, has potent anti-HIV activity in vitro, and may function as an endogenous HIV suppressor. therefore, we assessed serum AAT concentrations for association with HIV infection. Methods: In this cross-sectional study, serum AAT concentrations were measured in 66 persons with HIV infection and in 45 healthy persons (Controls). In the HIV-infected group, antiretroviral therapy (ART) use was assessed and CD4+ T cell levels and plasma HIV RNA were quantified. Results: Median AAT concentration was significantly lower in the HIV-infected group (1.64 mg/mL) in comparison with Controls (1.94 mg/μL; p=0.001). AAT reduction was most pronounced in the HIV-infected subgroup with CD4+ T cell levels >200 cells/μL in comparison with Controls (p<0.01). Serum AAT concentrations <1.0%mg/mL are clinically significant, and concentrations below this level were identified in 4.5% of the HIV infected group and in no Control subjects. No association between AAT levels and viral load or use of ART was observed in HIV-infected subjects. Conclusion: the association between reduced serum AAT concentration and HIV infection is consistent with a role for AAT as an endogenous HIV suppressor.


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