title: Persistently Elevated C-Reactive Protein Level in the First Year of Antiretroviral Therapy, Despite Virologic Suppression, Is Associated With HIV Disease Progression in Resource-Constrained Settings.
abstract: A case-cohort analysis of human immunodeficiency virus (HIV)-infected individuals receiving antiretroviral therapy (ART) was performed within a multicountry randomized trial (PEARLS) to assess the prevalence of persistently elevated C-reactive protein (CRP) levels, based on serial measurements of CRP levels, and their association with HIV clinical failure. A persistently elevated CRP level in plasma (defined as ≥ 5 mg/L at both baseline and 24 weeks after ART initiation) was observed in 50 of 205 individuals (24%). A persistently elevated CRP level but not an elevated CRP level only at a single time point was independently associated with increased clinical failure, compared with a persistently low CRP level, despite achievement of virologic suppression. Serial monitoring of CRP levels could identify individuals who are at highest risk of HIV progression and may benefit from future adjunct antiinflammatory therapies.
authors.affiliation: Department of Medicine, Johns Hopkins University School of Medicine, Baltimore, Maryland.
authors.forename: Rupak
authors.initials: R
authors.lastname: Shivakoti
authors.affiliation: Department of Medicine, Johns Hopkins University School of Medicine, Baltimore, Maryland.
authors.forename: Wei-Teng
authors.initials: WT
authors.lastname: Yang
authors.affiliation: Malawi College of Medicine-Johns Hopkins University Research Project, Blantyre.
authors.forename: Sima
authors.initials: S
authors.lastname: Berendes
authors.affiliation: Department of Medicine, University of Witwatersrand, Johannesburg.
authors.forename: Noluthando
authors.initials: N
authors.lastname: Mwelase
authors.affiliation: UNC Project-Malawi, Lilongwe, Malawi.
authors.forename: Cecilia
authors.initials: C
authors.lastname: Kanyama
authors.affiliation: Durban International Clinical Research Site, Durban University of Technology, South Africa.
authors.forename: Sandy
authors.initials: S
authors.lastname: Pillay
authors.affiliation: University of Zimbabwe Clinical Research Centre, Harare.
authors.forename: Wadzanai
authors.initials: W
authors.lastname: Samaneka
authors.affiliation: Hospital Nossa Senhora de Conceição, Porto Alegre.
authors.forename: Breno
authors.initials: B
authors.lastname: Santos
authors.affiliation: YR Gaitonde Center for AIDS Research and Education, Chennai.
authors.forename: Selvamuthu
authors.initials: S
authors.lastname: Poongulali
authors.affiliation: National AIDS Research Institute, Pune, India.
authors.forename: Srikanth
authors.initials: S
authors.lastname: Tripathy
authors.affiliation: Les Centres GHESKIO, Port-Au-Prince, Haiti.
authors.forename: Cynthia
authors.initials: C
authors.lastname: Riviere
authors.affiliation: Asociacion Civil Impacta Salud y Educacion, Lima, Peru.
authors.forename: Javier R
authors.initials: JR
authors.lastname: Lama
authors.affiliation: STD/AIDS Clinical Research Laboratory, Instituto de Pesquisa Clinica Evandro Chagas, Fundacao Oswaldo Cruz, Rio de Janeiro, Brazil.
authors.forename: Sandra W
authors.initials: SW
authors.lastname: Cardoso
authors.affiliation: Research Institute for Health Sciences, Chiang Mai, Thailand.
authors.forename: Patcharaphan
authors.initials: P
authors.lastname: Sugandhavesa
authors.affiliation: Department of Medicine, Johns Hopkins University School of Medicine, Baltimore, Maryland.
authors.forename: Ashwin
authors.initials: A
authors.lastname: Balagopal
authors.affiliation: Department of Medicine, Johns Hopkins University School of Medicine, Baltimore, Maryland.
authors.forename: Nikhil
authors.initials: N
authors.lastname: Gupte
authors.affiliation: Department of Ophthalmology, Johns Hopkins University School of Medicine, Baltimore, Maryland.
authors.forename: Richard D
authors.initials: RD
authors.lastname: Semba
authors.affiliation: Division of Infectious Diseases, Department of Medicine, University of Colorado School of Medicine, Aurora.
authors.forename: Thomas B
authors.initials: TB
authors.lastname: Campbell
authors.affiliation: Department of Medicine, Johns Hopkins University School of Medicine, Baltimore, Maryland.
authors.forename: Robert C
authors.initials: RC
authors.lastname: Bollinger
authors.affiliation: Department of Medicine, Johns Hopkins University School of Medicine, Baltimore, Maryland.
authors.forename: Amita
authors.initials: A
authors.lastname: Gupta
mesh_terms: D000328:Adult; D019380:Anti-HIV Agents / Q000627:therapeutic use*; D002097:C-Reactive Protein / Q000378:metabolism*; D016022:Case-Control Studies; D005260:Female; D014943:Global Health; D015658:HIV Infections / Q000097:blood / Q000188:drug therapy* / Q000473:pathology; D006801:Humans; D007249:Inflammation; D008297:Male; D017211:Treatment Failure
chemical_list: D019380:Anti-HIV Agents; D002097:C-Reactive Protein
keywords: CRP; HIV; antiretroviral therapy; inflammation; persistent inflammation