title: Biomarkers of inflammation in HIV-infected Peruvian men and women before and during suppressive antiretroviral therapy.
abstract: OBJECTIVE
  Inflammatory biomarkers associated with cardiovascular disease are elevated in HIV-infected persons. These biomarkers improve with antiretroviral therapy (ART) but do not normalize to values observed in HIV-uninfected adults. Little is known regarding biomarkers of inflammation in HIV-infected Peruvians, in whom an increased burden of infectious diseases may exacerbate inflammation, and women, in whom sex difference may alter inflammation compared with men.
  
  
  METHODS
  Peruvians initiating first-line ART were enrolled in a prospective observational study. Individuals with suppression of HIV RNA plasma loads to less than 30 copies/ml when determined quarterly over 24 months of ART, had biomarkers of inflammation and cellular activation measured pre-ART and at 24-months of ART, and evaluated for associations with sex and clinical parameters.
  
  
  RESULTS
  Pre-ART high-sensitivity C-reactive protein (hsCRP) values of men were in the high-risk cardiovascular disease category (>3.0 mg/l) more frequently compared with women (P = 0.02); most women's values were in the low/average-risk categories. At 24 months of suppressive ART, hsCRP concentrations decreased in men (P = 0.03), but tended to increase in women, such that the proportion with high-risk hsCRP did not differ by sex. Pre-ART, soluble CD163 concentrations were higher in women compared with men (P = 0.02), and remained higher after 24 months of suppressive ART (P = 0.02). All other inflammatory biomarkers (P < 0.03) decreased across sexes. Biomarker concentrations were not associated with BMI or coinfections.
  
  
  CONCLUSIONS
  Elevated inflammatory biomarkers persisted despite 24 months of suppressive ART in a subset of Peruvians, and to a greater extent in women compared with men. These findings suggest that lifestyle or pharmacologic interventions may be required to optimize the health of HIV-infected Peruvians, particularly women.
authors.affiliation: aHospital Nacional dos de Mayo, Lima, Peru bDepartment of Pediatrics, University of Washington cCenter for Global Infectious Disease Research, Seattle Children's Hospital Research Institute dDepartment of Global Health eDepartment of Obstetrics and Gynecology, University of Washington, Seattle, Washington fInvestigaciones Médicas en Salud (INMENSA), Lima, Peru gDepartment of Medicine hDepartment of Laboratory Medicine, University of Washington, Seattle, Washington, USA. *Eduardo Ticonaa and Marta E. Bull contributed equally to the writing of this article. †Currently involved with the Global Alliance to Prevent Prematurity and Stillbirth (GAPPS) program, Seattle Children's Hospital, Seattle, Washington, USA. ‡Currently with the Vincent Center for Reproductive Biology, Massachusetts General Hospital, Boston, Massachusetts, USA.
authors.forename: Eduardo
authors.initials: E
authors.lastname: Ticona
authors.forename: Marta E
authors.initials: ME
authors.lastname: Bull
authors.forename: Jaime
authors.initials: J
authors.lastname: Soria
authors.forename: Kenneth
authors.initials: K
authors.lastname: Tapia
authors.forename: Jillian
authors.initials: J
authors.lastname: Legard
authors.forename: Sheila M
authors.initials: SM
authors.lastname: Styrchak
authors.forename: Corey
authors.initials: C
authors.lastname: Williams
authors.forename: Caroline
authors.initials: C
authors.lastname: Mitchell
authors.forename: Alberto
authors.initials: A
authors.lastname: La Rosa
authors.forename: Alberto L A
authors.initials: AL
authors.lastname: Rosa
authors.forename: Robert W
authors.initials: RW
authors.lastname: Coombs
authors.forename: Lisa M
authors.initials: LM
authors.lastname: Frenkel
mesh_terms: D000328:Adult; D044966:Anti-Retroviral Agents / Q000627:therapeutic use*; D015415:Biomarkers / Q000097:blood*; D005260:Female; D015658:HIV Infections / Q000188:drug therapy* / Q000473:pathology*; D006801:Humans; D007249:Inflammation / Q000473:pathology*; D008297:Male; D010568:Peru; D011446:Prospective Studies; D012737:Sex Factors
chemical_list: D044966:Anti-Retroviral Agents; D015415:Biomarkers