Proteinuria, creatinine clearance, and immune activation in antiretroviral-naive HIV-infected subjects.
Because both renal disease and immune activation predict progression to acquired immunodeficiency syndrome (AIDS), we evaluated the associations between proteinuria>or=1+, as determined by dipstick analysis (7 [7%] of 1012 subjects); creatinine clearance of <90 mL/min (195 [18%] of 1071 subjects); and percentages of peripheral activated CD8 cells (CD8+CD38+HLA-DR+ cells) in antiretroviral-naive, human immunodeficiency virus (HIV)-infected subjects who were enrolled in AIDS Clinical Trials Group studies 384 and A5095. Proteinuria, but not creatinine clearance, was associated with higher percentages of CD8+CD38+HLA-DR+ cells (55% vs. 50%; P=.01), with even more pronounced differences noted among men and among blacks and Hispanics. Proteinuria may be a surrogate measurement of greater immune activation in HIV-infected patients initiating antiretroviral therapy.
Gupta
Samir K
SK
Indiana University School of Medicine, Wishard Hospital, Indianapolis, IN 46202, USA. sgupta1@iupui.edu
Komarow
Lauren
L
Gulick
Roy M
RM
Pollard
Richard B
RB
Robbins
Gregory K
GK
Franceschini
Nora
N
Szczech
Lynda A
LA
Koletar
Susan L
SL
Kalayjian
Robert C
RC
D000328:Adult; D019380:Anti-HIV Agents / Q000008:administration & dosage* / Q000627:therapeutic use*; D018414:CD8-Positive T-Lymphocytes / Q000276:immunology*; D003404:Creatinine / Q000097:blood / Q000652:urine*; D003430:Cross-Sectional Studies; D005260:Female; D015658:HIV Infections / Q000188:drug therapy* / Q000652:urine; D006801:Humans; D008297:Male; D011507:Proteinuria
D019380:Anti-HIV Agents; D003404:Creatinine