Rifaximin has a marginal impact on microbial translocation, T-cell activation and inflammation in HIV-positive immune non-responders to antiretroviral therapy - ACTG A5286. Conference Paper uri icon



  • BACKGROUND: Rifaximin, a nonabsorbable antibiotic that decreases lipopolysaccharide (LPS) in cirrhotics, may decrease the elevated levels of microbial translocation, T-cell activation and inflammation in human immunodeficiency virus (HIV)-positive immune nonresponders to antiretroviral therapy (ART). METHODS: HIV-positive adults receiving ART for ≥96 weeks with undetectable viremia for ≥48 weeks and CD4(+) T-cell counts <350 cells/mm(3) were randomized 2:1 to rifaximin versus no study treatment for 4 weeks. T-cell activation, LPS, and soluble CD14 were measured at baseline and at weeks 2, 4, and 8. Wilcoxon rank sum tests compared changes between arms. RESULTS: Compared with no study treatment (n = 22), rifaximin (n = 43) use was associated with a significant difference between study arms in the change from baseline to week 4 for CD8(+)T-cell activation (median change, 0.0% with rifaximin vs +0.6% with no treatment; P = .03). This difference was driven by an increase in the no-study-treatment arm because there was no significant change within the rifaximin arm. Similarly, although there were significant differences between study arms in change from baseline to week 2 for LPS and soluble CD14, there were no significant changes within the rifaximin arm. CONCLUSIONS: In immune nonresponders to ART, rifaximin minimally affected microbial translocation and CD8(+)T-cell activation. Trial registration number. NCT01466595.


  • Wilkin, Timothy
  • Tenorio, Allan R
  • Chan, Ellen S
  • Bosch, Ronald J
  • Macatangay, Bernard J C
  • Read, Sarah W
  • Yesmin, Suria
  • Taiwo, Babafemi
  • Margolis, David M
  • Jacobson, Jeffrey M
  • Landay, Alan L
  • Wilson, Cara C

publication date

  • September 11, 2014



  • Anti-Bacterial Agents
  • Antiretroviral Therapy, Highly Active
  • Bacterial Translocation
  • CD8-Positive T-Lymphocytes
  • HIV Infections
  • Lymphocyte Activation
  • Rifamycins


PubMed Central ID

  • PMC4334803

Scopus Document Identifier

  • 84939509426

Digital Object Identifier (DOI)

  • 10.1093/infdis/jiu515

PubMed ID

  • 25214516

Additional Document Info


  • 211


  • 5