title: HIV infection, antiretroviral therapy initiation and longitudinal changes in biomarkers of organ function.
abstract: BACKGROUND
  HIV is associated with end-organ diseases of aging via unclear mechanisms. Longitudinally assessing how HIV infection and ART initiation affect biomarkers of end organ function/disease could clarify these mechanisms. We investigated longitudinal changes in clinical biomarkers following 1) HIV infection and 2) ART initiation with evidence of viral suppression.
  
  
  METHODS
  
  
  
  METHODS
  Veterans Aging COHORT Study Virtual COHORT (VACS VC). VACS VC is a longitudinal cohort of HIV infected (HIV+) and race-ethnicity, sex, age, and clinical site-matched uninfected Veterans enrolled in the same calendar year.
  
  
  METHODS
  a negative and successively positive (>six months) HIV antibody test. We used Wilcoxon signedrank tests to analyze 1) the effect of HIV infection on lipids, renal, hepatic and hematologic/cardiovascular biomarkers and 2)whether ART initiation with HIV-1 RNA<500 cpm reverts any changes back to pre-HIV levels.
  
  
  RESULTS
  422 Veterans had at least 1 biomarker measurement available prior to HIV infection and prior to ART initiation. 297 had at least 1 biomarker measurement available prior to HIV infection and after ART initiation with evidence of viral suppression. Mean age prior to HIV infection was 43 years. HIV infection was associated with reduction in total cholesterol, HDL cholesterol, LDL cholesterol, serum albumin, ALT, platelet count, hemoglobin and elevation of FIB-4 score and triglycerides. These changes occurred without significant changes in BMI. ART initiation (with HIV-1 RNA<500cpm) did not reverse alteration in triglycerides, LDL cholesterol, hemoglobin, or FIB-4 to pre-HIV infection levels.
  
  
  CONCLUSIONS
  HIV infection is associated with longitudinal changes in serum levels of several biomarkers of end-organ function/disease and mortality. Multiple biomarkers (triglycerides, LDL cholesterol, hemoglobin, and FIB-4 ) remain altered from levels prior to HIV infection levels even following inititiation of ART and evidence of viral suppression. These results give insights into underlying mechanisms of increased risk for aging-related chronic diseases in the context of HIV infection.
authors.forename: Kaku A
authors.initials: KA
authors.lastname: So-Armah
authors.forename: Joyce
authors.initials: J
authors.lastname: Chang
authors.forename: Charles
authors.initials: C
authors.lastname: Alcorn
authors.forename: Vincent
authors.initials: V
authors.lastname: Lo Re
authors.forename: Jason V
authors.initials: JV
authors.lastname: Baker
authors.forename: Russell
authors.initials: R
authors.lastname: Tracy
authors.forename: Adeel A
authors.initials: AA
authors.lastname: Butt
authors.forename: Brian K
authors.initials: BK
authors.lastname: Agan
authors.forename: David
authors.initials: D
authors.lastname: Rimland
authors.forename: Cynthia L
authors.initials: CL
authors.lastname: Gibert
authors.forename: Matthew B
authors.initials: MB
authors.lastname: Goetz
authors.forename: Krisann K
authors.initials: KK
authors.lastname: Oursler
authors.forename: Maria C
authors.initials: MC
authors.lastname: Rodriguez-Barradas
authors.forename: Lewis H
authors.initials: LH
authors.lastname: Kuller
authors.forename: Sheldon T
authors.initials: ST
authors.lastname: Brown
authors.forename: James H
authors.initials: JH
authors.lastname: Stein
authors.forename: Melissa
authors.initials: M
authors.lastname: Skanderson
authors.forename: Amy C
authors.initials: AC
authors.lastname: Justice
authors.affiliation: 230 McKee Place, Pittsburgh, PA 15213, USA. freibergms@upmc.edu.
authors.forename: Matthew S
authors.initials: MS
authors.lastname: Freiberg
mesh_terms: D000328:Adult; D019380:Anti-HIV Agents / Q000009:adverse effects / Q000627:therapeutic use*; D015415:Biomarkers / Q000097:blood; D001786:Blood Glucose / Q000032:analysis; D001794:Blood Pressure; D018791:CD4 Lymphocyte Count; D003920:Diabetes Mellitus / Q000097:blood; D005260:Female; D015658:HIV Infections / Q000097:blood / Q000150:complications / Q000188:drug therapy; D015497:HIV-1; D006526:Hepatitis C / Q000097:blood; D006801:Humans; D019161:Hydroxymethylglutaryl-CoA Reductase Inhibitors / Q000097:blood; D006973:Hypertension / Q000503:physiopathology; D007674:Kidney Diseases / Q000097:blood; D008055:Lipids / Q000097:blood; D008107:Liver Diseases / Q000097:blood; D008137:Longitudinal Studies; D008297:Male; D008875:Middle Aged; D012367:RNA, Viral; D014728:Veterans
chemical_list: D019380:Anti-HIV Agents; D015415:Biomarkers; D001786:Blood Glucose; D019161:Hydroxymethylglutaryl-CoA Reductase Inhibitors; D008055:Lipids; D012367:RNA, Viral