title: Markers of inflammation, coagulation, and renal function are elevated in adults with HIV infection.
abstract: 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.
authors.affiliation: University of Minnesota, Minneapolis, Minnesota 55414 , USA. jacquie@ccbr.umn.edu
authors.forename: Jacqueline
authors.initials: J
authors.lastname: Neuhaus
authors.forename: David R
authors.initials: DR
authors.lastname: Jacobs
authors.forename: Jason V
authors.initials: JV
authors.lastname: Baker
authors.forename: Alexandra
authors.initials: A
authors.lastname: Calmy
authors.forename: Daniel
authors.initials: D
authors.lastname: Duprez
authors.forename: Alberto
authors.initials: A
authors.lastname: La Rosa
authors.forename: Lewis H
authors.initials: LH
authors.lastname: Kuller
authors.forename: Sarah L
authors.initials: SL
authors.lastname: Pett
authors.forename: Matti
authors.initials: M
authors.lastname: Ristola
authors.forename: Michael J
authors.initials: MJ
authors.lastname: Ross
authors.forename: Michael G
authors.initials: MG
authors.lastname: Shlipak
authors.forename: Russell
authors.initials: R
authors.lastname: Tracy
authors.forename: James D
authors.initials: JD
authors.lastname: Neaton
mesh_terms: 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
chemical_list: 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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