Markers of inflammation, coagulation, and renal function are elevated in adults with HIV infection.
BACKGROUND
Human immunodeficiency virus (HIV) replication and immune activation may increase inflammation and coagulation biomarkers. Limited data exist comparing such biomarkers in persons with and without HIV infection.


METHODS
For persons 45-76 years of age, levels of high-sensitivity C-reactive protein (hsCRP), interleukin (IL)-6, D-dimer, and cystatin C were compared in 494 HIV-infected individuals in the Strategies for Management of Anti-Retroviral Therapy (SMART) study and 5386 participants in the Multi-Ethnic Study of Atherosclerosis (MESA) study. For persons 33-44 years of age, hsCRP and IL-6 levels were compared in 287 participants in the SMART study and 3231 participants in the Coronary Artery Development in Young Adults (CARDIA) study.


RESULTS
hsCRP and IL-6 levels were 55% (P < . 001) and 62 (P < . 001) higher among HIV-infected participants than among CARDIA study participants. Compared with levels noted in MESA study participants, hsCRP, IL-6, D-dimer, and cystatin C levels were 50%, 152%, 94%, and 27% higher, respectively (P < . 001, for each), among HIV-infected participants. HIV-infected participants receiving antiretroviral therapy who had HIV RNA levels 400 copies/mL had levels higher (by 21% to 60%) (P < . 001) than those in the general population, for all biomarkers.


CONCLUSIONS
hsCRP, IL-6, D-dimer, and cystatin C levels are elevated in persons with HIV infection and remain so even after HIV RNA levels are suppressed with antiretroviral therapy. Additional research is needed on the pathophysiology of HIV-induced activation of inflammatory and coagulation pathways, to guide potential interventions.
Neuhaus
Jacqueline
J
University of Minnesota, Minneapolis, Minnesota 55414 , USA. jacquie@ccbr.umn.edu
Jacobs
David R
DR
Baker
Jason V
JV
Calmy
Alexandra
A
Duprez
Daniel
D
La Rosa
Alberto
A
Kuller
Lewis H
LH
Pett
Sarah L
SL
Ristola
Matti
M
Ross
Michael J
MJ
Shlipak
Michael G
MG
Tracy
Russell
R
Neaton
James D
JD
D000328:Adult; D000368:Aged; D019380:Anti-HIV Agents / Q000627:therapeutic use; D015415:Biomarkers; D001778:Blood Coagulation Disorders / Q000473:pathology*; D002097:C-Reactive Protein / Q000032:analysis; D055316:Cystatin C / Q000097:blood; D005260:Female; D005338:Fibrin Fibrinogen Degradation Products / Q000032:analysis; D015658:HIV Infections / Q000150:complications* / Q000188:drug therapy; D006801:Humans; D007249:Inflammation / Q000473:pathology*; D015850:Interleukin-6 / Q000097:blood; D007674:Kidney Diseases / Q000473:pathology*; D008297:Male; D008875:Middle Aged; D019562:Viral Load
D019380:Anti-HIV Agents; D015415:Biomarkers; D055316:Cystatin C; D005338:Fibrin Fibrinogen Degradation Products; D015850:Interleukin-6; C036309:fibrin fragment D; D002097:C-Reactive Protein
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