COMPLEMENTO, PLAQUETAS Y NETOSIS: MICROINFLAMACIÓN SILENTE EN VIH VIRORREPRIMIDO
Authors/Creators
- 1. Universidad de Antioquia, Medellín, Colombia
- 2. Universidad Santiago de Cali, Programa de Medicina Cali; Valle del Cauca, Colombia
Description
Tipo de artículo: Caso clínico
La persistencia de inflamación inmunometabólica en personas que viven con VIH virorreprimido constituye un desafío clínico emergente, asociado a mayor carga de comorbilidades no definitorias de SIDA y riesgo cardiovascular precoz. El objetivo de esta revisión y reporte de caso es analizar el papel fisiopatológico del eje complemento–plaquetas–NETosis (C2–C5a/C5aR–CD62P–NETs) en la activación inmunotrombótica subclínica y su relevancia diagnóstica y terapéutica. Se realizó una búsqueda narrativa estructurada en PubMed, Scopus y Web of Science, incluyendo estudios experimentales, observacionales y ensayos clínicos publicados entre 2017–2025 sobre inflamación residual, inmunotrombosis y biomarcadores del complemento en VIH controlado. Los principales hallazgos indican que, incluso bajo supresión virológica sostenida, persiste disregulación del complemento con disminución de C2 y aumento de C5a, acompañada de activación plaquetaria (CD62P-MFI) e inducción de NETosis, mecanismos que favorecen microtrombosis endotelial y enfermedad cardiovascular silenciosa.
El caso clínico presentado ejemplifica la relevancia de estos hallazgos y la necesidad de evaluación inmunológica ampliada ante síntomas inespecíficos. Se concluye destacando el potencial clínico de biomarcadores inmunotrombóticos para estratificación individualizada y de terapias dirigidas al eje C5a/C5aR.
Abstract (English)
Article type: Clinical case
Persistent immunometabolic inflammation in virally suppressed people living with HIV (PLWH) represents an emerging clinical challenge linked to increased non-AIDS comorbidities and early cardiovascular risk. This review and case report aim to analyze the physiological role of the complement–platelet–NETosis axis (C2–C5a/C5aR–CD62P–NETs) in subclinical immunothrombotic activation and their diagnostic and therapeutic implications. A structured narrative search was conducted in PubMed, Scopus, and Web of Science, including experimental, observational, and clinical trial evidence published between 2017–2025 related to residual inflammation, immunothrombosis, and complement biomarkers in controlled HIV. Findings indicate that, despite sustained viral suppression, persistent complement dysregulation occurs with decreased C2 and elevated C5a, along with platelet activation (CD62P-MFI) and NETosis induction, promoting endothelial microthrombosis and silent cardiovascular disease.
The presented case illustrates the clinical relevance of these mechanisms and supports expanded immunologic evaluation in PLWH with nonspecific symptoms. We conclude by highlighting the potential value of immunothrombotic biomarkers for
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Additional details
Additional titles
- Translated title (English)
- COMPLEMENT, PLATELETS AND NETOSIS: SILENT MICROINFLAMMATION IN VIROREPRESSED HIV
Identifiers
- ISSN
- 2530-5468
Dates
- Collected
-
2025-12-06manuscrito recibido
- Accepted
-
2026-01-16evaluación doble ciego
- Available
-
2026-01-29Publicación en numero de la revista
Software
- Repository URL
- https://revistacientificasanum.com/
References
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