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Review
. 2024 Aug 27:15:1470308.
doi: 10.3389/fimmu.2024.1470308. eCollection 2024.

Mechanisms underlying the development of type 1 diabetes in ART-treated people living with HIV: an enigmatic puzzle

Silvere D Zaongo  1 , Abel W Zongo  2 , Yaokai Chen  1
Affiliations
Review

Mechanisms underlying the development of type 1 diabetes in ART-treated people living with HIV: an enigmatic puzzle

Silvere D Zaongo et al. Front Immunol. .

Abstract

The immunopathogenesis of HIV infection remains poorly understood. Despite the widespread use of effective modern antiretroviral therapy (ART), people living with HIV (PLWH) are known to develop several comorbidities, including type 1 diabetes (T1DM). However, the etiology and critical mechanisms accounting for the onset of T1DM in the preceding context remain unknown. This article proposes to address this topic in order to provide further understanding and future research directions.

Keywords: ART; HIV; T1DM; antiretroviral therapy; mechanisms; type 1 diabetes.

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Conflict of interest statement

The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest.

Figures

Figure 1
Figure 1
Relationship between HIV infection and T1DM. From the evidence recorded in Table 1 , it is likely that other than Grave’s disease, opportunistic infections, autoimmune disorders, and hepatitis B or C infection may also be considered. From Yeh et al. (6). Reproduced under Creative Commons CC BY (CC BY 4.0).
Figure 2
Figure 2
The immunological basis of autoimmune diabetes. An overview of the implications of some innate immune cells and the gut microbiome is summarized in (A–E), respectively. In addition, the role of C-peptide should not be overlooked or underestimated. Indeed, as indicated by Washburn et al. (119), the presence of C-peptide contributes to (i) increase cells survival and (ii) decrease apoptosis process and reactive oxygen species (ROS) production. However, the levels of C-peptide are decreased in patients with T1DM which may favor β-cells death.
Figure 3
Figure 3
Mechanisms whereby a rapid increase in CD4+T-cells may mediate the development of T1DM in ART-treated PLWH.
Figure 4
Figure 4
Potential major roles played by the gut microbiome in the development of T1DM in ART-treated PLWH.
See this image and copyright information in PMC

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MeSH terms

Grants and funding

The author(s) declare financial support was received for the research, authorship, and/or publication of this article. This work was supported by the Chongqing AIDS Medical Research Center Construction Program, the Chongqing Disease Prevention and Public Health Research Center Construction Program, the Chongqing Key Public Health Disciplines Improvement Project, and the Chongqing Public Health Medical Center Research Initiation Fund (KYLW202321).

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