Microbial translocation in HIV infection: causes, consequences and treatment opportunities

Nat Rev Microbiol. 2012 Sep;10(9):655-66. doi: 10.1038/nrmicro2848. Epub 2012 Aug 13.


Systemic immune activation is increased in HIV-infected individuals, even in the setting of virus suppression with antiretroviral therapy. Although numerous factors may contribute, microbial products have recently emerged as potential drivers of this immune activation. In this Review, we describe the intestinal damage that occurs in HIV infection, the evidence for translocation of microbial products into the systemic circulation and the pathways by which these products activate the immune system. We also discuss novel therapies that disrupt the translocation of microbial products and the downstream effects of microbial translocation.

Publication types

  • Research Support, N.I.H., Extramural
  • Review

MeSH terms

  • Bacterial Infections / pathology
  • Bacterial Toxins / immunology
  • Bacterial Toxins / metabolism
  • Bacterial Translocation*
  • Gastrointestinal Tract / immunology
  • Gastrointestinal Tract / microbiology
  • Gastrointestinal Tract / pathology
  • HIV Infections / complications*
  • HIV Infections / immunology
  • Humans
  • Immunologic Factors / therapeutic use
  • Models, Biological


  • Bacterial Toxins
  • Immunologic Factors