Soluble tumor necrosis factor alpha receptors (sTNF-Rs) in HIV-1-infected intravenous drug users: change in circulating sTNF-R type II level and survival for AIDS patients.
This study in intravenous drug users (IVDUs) investigated differences in serum soluble tumor necrosis factor types I and II (sTNFR-I and II) concentrations in HIV-1-infected IVDUs and controls. This study also investigated whether changes of sTNFRs concentration affect the risk of death among patients with AIDS. A cross-sectional study of 54 subjects with AIDS, 47 HIV-seropositive IVDUs, 47 HIV-seronegative IVDUs, and 21 healthy subjects showed that sTNFRs concentration increases from healthy controls to AIDS patients through HIV-seronegative and HIV-seropositive subjects (p < 0.01). sTNFR-I concentration, however, was shown to be similar in HIV-seronegative IVDUs and healthy controls. In the longitudinal study, serum concentration of sTNFRs was determined near AIDS diagnosis in 21 IVDUs and 1 year later (start for the survival study). Cox proportional hazards regression was performed to assess the prognostic value of percent change of sTNFR level alone and in combination with T lymphocyte subsets, HIV-p24 antigenemia and opportunistic infections for death within 240 days. Uni- and multivariate Cox modelling for dichotomised variables according to its median showed an increase of sTNFR-II by at least 30% to be single significant predictor of death: crude relative risk 3.69, p = 0.03; adjusted relative risk 5.67, p = 0.02. Mean survival was 126 days in 11 patients whose sTNFR-II level increased by at least 30%, and 176 days in 10 patients with less change in sTNFR-II (p = 0.02).


CONCLUSIONS
sTNFRs concentration is higher in IVDUs than in healthy controls and is highest in AIDS patients. Survival of patients with AIDS is associated with variation in the concentration of sTNFR-II.
Ajello
F
F
Dipartimento di Igiene e Microbiologia G. D'Alessandro, Università degli Studi, Palermo, Italy.
La Licata
R
R
Lodato
M
M
Vitale
F
F
Bonura
F
F
Valenti
R
R
Bruno
M
M
Romano
N
N
D000163:Acquired Immunodeficiency Syndrome / Q000097:blood* / Q000401:mortality*; D000328:Adult; D003430:Cross-Sectional Studies; D005260:Female; D015658:HIV Infections / Q000097:blood*; D015497:HIV-1; D006801:Humans; D007558:Italy / Q000453:epidemiology; D008297:Male; D016016:Proportional Hazards Models; D018124:Receptors, Tumor Necrosis Factor; D015819:Substance Abuse, Intravenous / Q000097:blood*; D016019:Survival Analysis
D018124:Receptors, Tumor Necrosis Factor