Antiretroviral therapy reduces but does not normalize immune and vascular inflammatory markers in adults with chronic HIV infection in Kenya
| Autor: | Stephanie T. Page, Jerusha Nyabiage, Jessica Wagoner, Jerry S Zifodya, Stephen J. Polyak, John Kinuthia, Carey Farquhar, Sarah Masyuko, Gerald S. Bloomfield, Tecla M Temu, Celestine N. Wanjalla |
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| Rok vydání: | 2020 |
| Předmět: |
Adult
0301 basic medicine Immunology Lipopolysaccharide Receptors HIV Infections Inflammation Overweight Article 03 medical and health sciences 0302 clinical medicine Immune system medicine Humans Immunology and Allergy 030212 general & internal medicine business.industry Monocyte Viral Load medicine.disease Kenya Cross-Sectional Studies 030104 developmental biology Infectious Diseases medicine.anatomical_structure Anti-Retroviral Agents Biomarker (medicine) medicine.symptom business Viral load CD163 Biomarkers Dyslipidemia |
| Zdroj: | AIDS |
| ISSN: | 1473-5571 0269-9370 |
| DOI: | 10.1097/qad.0000000000002729 |
| Popis: | INTRODUCTION Markers of monocyte/macrophage activation and vascular inflammation are associated with HIV-related cardiovascular diseases (CVD) and mortality. We compared these markers among African people living with HIV (PLWH) and HIV-negative adults, and examined risk factors associated with elevated biomarkers (>75th percentile) in PLWH on antiretroviral therapy (ART). DESIGN Cross-sectional study. METHODS We measured serum concentrations of a gut integrity biomarker (intestinal-fatty acid binding protein), monocyte/macrophage activation biomarkers (soluble CD14 and CD163), and vascular inflammation biomarkers [soluble intercellular adhesion molecule 1 (sICAM-1) and soluble vascular adhesion molecule 1 (sVCAM-1)]. We assessed the relationship of these inflammatory parameters with HIV, using logistic regression adjusting for traditional CVD risk factors. RESULTS Among the 541 participants, median age was 43 years and half were female. Among 275 PLWH, median CD4 T-cell count and duration of ART use was 509 cells/μl and 8 years, respectively. PLWH had significantly higher prevalence of elevated inflammatory biomarkers compared with HIV-negative individuals even after adjustment for traditional CVD risk factors. Compared with individuals without HIV, the prevalence of elevated biomarkers was highest among persons with detectable viral load and CD4 T-cell counts 200 cells/μl or less. In a subanalysis among PLWH, nadir CD4 T-cell count 200 cells/μl or less was associated with elevated soluble CD14 (sCD14); dyslipidemia with elevated sCD14, sICAM-1, and sVCAM-1; and overweight/obesity with reduced sCD14. Longer ART exposure (>4 years) was associated with reduced sVCAM-1 and sICAM-1. CONCLUSION HIV and not traditional CVD risk factors is a primary contributor of monocyte/macrophage activation and inflammation despite ART. Anti-inflammatory therapies in addition to ART may be necessary to reduce these immune dysregulations and improve health outcomes of African PLWH. |
| Databáze: | OpenAIRE |
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