**4. Plasma exosomes in HIV-1 patient**

Exosomes play an important role in pathogenesis in HIV-1 patients. The exosomes in HIV-1 patients and their relationship in immune and oxidative stress response have been documented [49]. Exosome plasma proteomic profiles were identified and characterised in HIV patients of alcohol drinkers and cigarette smokers. The exosome proteins, such as hemopexin and properdin, could be used as a potential biomarker for physiological effects that may arise in HIV-infected individuals tobacco and alcohol abusers [50]. Exosome-associated most cytokines were observed in the HIV-1 infected patients. The exosomes purified from HIV-positive patients induced the CD38 expression in naive and central memory CD4+ and CD+ T cells leads to inflammation and viral propagation [12]. The expression levels of miR21 were lower in the plasma-derived exosome of HIV-1 elite controller with decreasing CD4 T cell count [51].
