Changes in Inflammation but Not in T-Cell Activation Precede Non-AIDS-Defining Events in a Case-Control Study of Patients on Long-term Antiretroviral Therapy. (22nd November 2017)

• Record Type: Journal Article
• Authors: Angelidou, Konstantia; Hunt, Peter W; Landay, Alan L; Wilson, Cara C; Rodriguez, Benigno; Deeks, Steven G; Bosch, Ronald J; Lederman, Michael M
• Is Part Of: Journal of infectious diseases. Volume 218:Number 2(2018)
• Page Start: 239
• Page End: 248
• Publication Date: 2017-11-22
• Subjects: HIV -- non-AIDS morbidity -- antiretroviral therapy -- inflammation -- T-cell activation; Communicable diseases -- Periodicals; Diseases -- Causes and theories of causation -- Periodicals; Medicine -- Periodicals; Communicable Diseases -- Periodicals; Electronic journals; 616.9
• DOI: 10.1093/infdis/jix666
• Languages: English
• ISSNs: 0022-1899

Abstract

Abstract : In an AIDS Clinical Trials Group nested case-control study, inflammation increased prior to non-AIDS events in treated HIV-infected adults. Abstract: Background: We examined changes in soluble inflammatory cytokines and T-cell activation after antiretroviral therapy (ART) initiation in an AIDS Clinical Trials Group (ACTG) nested case-control study. Methods: Cases were 143 human immunodeficiency virus (HIV)–infected adults who developed a non-AIDS event; 315 controls remained event-free. Specimens were tested pre-ART, year 1 post-ART, and at the visit preceding the event. Conditional logistic regression evaluated the associations of biomarker changes with non-AIDS events. Results: Inflammatory and most activation biomarkers declined from pre-ART to year 1 for cases and controls. Subsequently, inflammatory biomarkers remained mostly stable in controls but not cases. Cellular activation markers generally declined for both cases and controls between year 1 and the pre-event sampling. Controls with greater pre-ART RNA levels or lower CD4 + levels had higher biomarker levels while also experiencing greater biomarker declines in the first year of ART. Changes in biomarkers to year 1 showed no significant associations with non-AIDS events. Cases, however, had significantly greater increases in all plasma biomarkers (but not cellular activation) from year 1 to the visit preceding the event. Conclusions: Inflammation increases prior to non-AIDS events in treated HIV-infected adults. These biomarker changes may reflect subclinical disease processes or other alterations in the inflammatory environment that causally contribute to disease. Clinical Trials Registration: NCT00001137.