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Antiretroviral therapy reduces but does not normalize immune and vascular inflammatory markers in adults with chronic HIV infection in Kenya.

Publication ,  Journal Article
Temu, TM; Zifodya, JS; Polyak, SJ; Wagoner, J; Wanjalla, CN; Masyuko, S; Nyabiage, J; Kinuthia, J; Bloomfield, GS; Page, ST; Farquhar, C
Published in: AIDS
January 1, 2021

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.

Duke Scholars

Published In

AIDS

DOI

EISSN

1473-5571

Publication Date

January 1, 2021

Volume

35

Issue

1

Start / End Page

45 / 51

Location

England

Related Subject Headings

  • Virology
  • Viral Load
  • Lipopolysaccharide Receptors
  • Kenya
  • Humans
  • HIV Infections
  • Cross-Sectional Studies
  • Biomarkers
  • Anti-Retroviral Agents
  • Adult
 

Citation

APA
Chicago
ICMJE
MLA
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Temu, T. M., Zifodya, J. S., Polyak, S. J., Wagoner, J., Wanjalla, C. N., Masyuko, S., … Farquhar, C. (2021). Antiretroviral therapy reduces but does not normalize immune and vascular inflammatory markers in adults with chronic HIV infection in Kenya. AIDS, 35(1), 45–51. https://doi.org/10.1097/QAD.0000000000002729
Temu, Tecla M., Jerry S. Zifodya, Stephen J. Polyak, Jessica Wagoner, Celestine N. Wanjalla, Sarah Masyuko, Jerusha Nyabiage, et al. “Antiretroviral therapy reduces but does not normalize immune and vascular inflammatory markers in adults with chronic HIV infection in Kenya.AIDS 35, no. 1 (January 1, 2021): 45–51. https://doi.org/10.1097/QAD.0000000000002729.
Temu TM, Zifodya JS, Polyak SJ, Wagoner J, Wanjalla CN, Masyuko S, et al. Antiretroviral therapy reduces but does not normalize immune and vascular inflammatory markers in adults with chronic HIV infection in Kenya. AIDS. 2021 Jan 1;35(1):45–51.
Temu, Tecla M., et al. “Antiretroviral therapy reduces but does not normalize immune and vascular inflammatory markers in adults with chronic HIV infection in Kenya.AIDS, vol. 35, no. 1, Jan. 2021, pp. 45–51. Pubmed, doi:10.1097/QAD.0000000000002729.
Temu TM, Zifodya JS, Polyak SJ, Wagoner J, Wanjalla CN, Masyuko S, Nyabiage J, Kinuthia J, Bloomfield GS, Page ST, Farquhar C. Antiretroviral therapy reduces but does not normalize immune and vascular inflammatory markers in adults with chronic HIV infection in Kenya. AIDS. 2021 Jan 1;35(1):45–51.

Published In

AIDS

DOI

EISSN

1473-5571

Publication Date

January 1, 2021

Volume

35

Issue

1

Start / End Page

45 / 51

Location

England

Related Subject Headings

  • Virology
  • Viral Load
  • Lipopolysaccharide Receptors
  • Kenya
  • Humans
  • HIV Infections
  • Cross-Sectional Studies
  • Biomarkers
  • Anti-Retroviral Agents
  • Adult