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Interruption of antiretroviral therapy is associated with increased plasma cystatin C.

Publication ,  Journal Article
Mocroft, A; Wyatt, C; Szczech, L; Neuhaus, J; El-Sadr, W; Tracy, R; Kuller, L; Shlipak, M; Angus, B; Klinker, H; Ross, M; INSIGHT SMART Study Group,
Published in: AIDS
January 2, 2009

BACKGROUND: Cystatin C has been proposed as an alternative marker of renal function. We sought to determine whether participants randomized to episodic use of antiretroviral therapy guided by CD4 cell count (drug conservation) had altered cystatin C levels compared with those randomized to continuous antiretroviral therapy (viral suppression) in the Strategies for Management of Antiretroviral Therapy trial, and to identify factors associated with increased cystatin C. METHODS: Cystatin C was measured in plasma collected at randomization, 1, 2, 4, 8 and 12 months after randomization in a random sample of 249 and 250 participants in the drug conservation and viral suppression groups, respectively. Logistic regression was used to model the odds of at least 0.15 mg/dl increase in cystatin C (1 SD) in the first month after randomization, adjusting for demographic and clinical characteristics. RESULTS: At randomization, mean (SD) cystatin C level was 0.99 (0.26 mg/dl) and 1.01 (0.28 mg/dl) in the drug conservation and viral suppression arms, respectively (P = 0.29). In the first month after randomization, 21.8 and 10.6% had at least 0.15 mg/dl increase in cystatin C in the drug conservation and viral suppression arms, respectively (P = 0.0008). The difference in cystatin C between the treatment arms was maintained through 1 year after randomization. After adjustment, participants in the viral suppression arm had significantly reduced odds of at least 0.15 mg/dl increase in cystatin C in the first month (odds ratio 0.42; 95% confidence interval 0.23-0.74, P = 0.0023). CONCLUSION: These results demonstrate that interruption of antiretroviral therapy is associated with an increase in cystatin C, which may reflect worsened renal function.

Duke Scholars

Published In

AIDS

DOI

EISSN

1473-5571

Publication Date

January 2, 2009

Volume

23

Issue

1

Start / End Page

71 / 82

Location

England

Related Subject Headings

  • Virology
  • Viral Load
  • Middle Aged
  • Male
  • Lipids
  • Kidney
  • Humans
  • HIV Infections
  • Glomerular Filtration Rate
  • Female
 

Citation

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ICMJE
MLA
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Mocroft, A., Wyatt, C., Szczech, L., Neuhaus, J., El-Sadr, W., Tracy, R., … INSIGHT SMART Study Group, . (2009). Interruption of antiretroviral therapy is associated with increased plasma cystatin C. AIDS, 23(1), 71–82. https://doi.org/10.1097/QAD.0b013e32831cc129
Mocroft, Amanda, Christina Wyatt, Lynda Szczech, Jacquie Neuhaus, Wafaa El-Sadr, Russell Tracy, Lewis Kuller, et al. “Interruption of antiretroviral therapy is associated with increased plasma cystatin C.AIDS 23, no. 1 (January 2, 2009): 71–82. https://doi.org/10.1097/QAD.0b013e32831cc129.
Mocroft A, Wyatt C, Szczech L, Neuhaus J, El-Sadr W, Tracy R, et al. Interruption of antiretroviral therapy is associated with increased plasma cystatin C. AIDS. 2009 Jan 2;23(1):71–82.
Mocroft, Amanda, et al. “Interruption of antiretroviral therapy is associated with increased plasma cystatin C.AIDS, vol. 23, no. 1, Jan. 2009, pp. 71–82. Pubmed, doi:10.1097/QAD.0b013e32831cc129.
Mocroft A, Wyatt C, Szczech L, Neuhaus J, El-Sadr W, Tracy R, Kuller L, Shlipak M, Angus B, Klinker H, Ross M, INSIGHT SMART Study Group. Interruption of antiretroviral therapy is associated with increased plasma cystatin C. AIDS. 2009 Jan 2;23(1):71–82.

Published In

AIDS

DOI

EISSN

1473-5571

Publication Date

January 2, 2009

Volume

23

Issue

1

Start / End Page

71 / 82

Location

England

Related Subject Headings

  • Virology
  • Viral Load
  • Middle Aged
  • Male
  • Lipids
  • Kidney
  • Humans
  • HIV Infections
  • Glomerular Filtration Rate
  • Female