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Soluble biomarkers of immune activation and inflammation in HIV infection: impact of 2 years of effective first‐line combination antiretroviral therapy
Author(s) -
Hattab S,
Guiguet M,
Carcelain G,
Fourati S,
Guihot A,
Autran B,
Caby F,
Marcelin AG,
Costagliola D,
Katlama C
Publication year - 2015
Publication title -
hiv medicine
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.53
H-Index - 79
eISSN - 1468-1293
pISSN - 1464-2662
DOI - 10.1111/hiv.12257
Subject(s) - cart , medicine , biomarker , immune system , gastroenterology , inflammation , immunology , odds ratio , mechanical engineering , biochemistry , chemistry , engineering
Objectives The aim of the study was to assess the impact of rapid and sustained viral control produced by combination antiretroviral therapy (c ART ) on HIV ‐associated immune activation and inflammation. Methods In this longitudinal observational study, we examined changes in interleukin‐6 ( IL ‐6), interferon‐γ‐inducible protein‐10 ( IP ‐10), monokine induced by interferon‐γ ( MIG ) and soluble CD 14 (s CD 14) levels during 2 years of effective first‐line c ART . Biomarker levels before and after c ART were compared with those observed in healthy subjects, using the Wilcoxon signed rank test. Elevated biomarker levels were defined with respect to values for healthy subject (mean + 2 standard deviations). Factors associated with persistently elevated biomarker levels after 2 years of c ART were identified by logistic regression. Results We included in the study 139 patients with a median HIV ‐1 RNA level of 4.8 log 10 HIV ‐1 RNA copies/mL and a median CD 4 cell count of 294 cells/μL at c ART initiation [day 0 ( D 0)]. At D 0, all biomarker levels were higher than in healthy subjects ( P < 0.05). After 2 years of c ART , IL ‐6, IP ‐10 and MIG levels fell significantly, by a median of 0.54, 420 and 1107 pg/mL, respectively (all P < 0.001), and were no longer elevated in > 75% of patients. In contrast, s CD 14 levels did not change significantly (0.18 × 10 6 pg/mL; P = 0.102) and remained elevated. Older age was associated with elevated levels of IP ‐10 [odds ratio ( OR ) 1.60 per 10 years older; P = 0.047] and MIG ( OR 1.92 per 10 years older; P = 0.007) after 2 years of c ART . Conclusions The rapid and sustained viral suppression produced by first‐line c ART reduced IL ‐6, IP ‐10 and MIG to normal levels, while s CD 14, a marker of monocyte activation, remained elevated. High levels of IP ‐10 and MIG tended to persist in older patients.