Oxidative Stress Predicts All-Cause Mortality in HIV-Infected Patients.
We aimed to assess whether oxidative stress is a predictor of mortality in HIV-infected patients.



We conducted a nested case-control study in CoRIS, a contemporary, multicentre cohort of HIV-infected patients, antiretroviral-naïve at entry, launched in 2004. Cases were patients who died with available stored plasma samples collected. Two age and sex-matched controls for each case were selected. We measured F2-isoprostanes (F2-IsoPs) and malondialdehyde (MDA) plasma levels in the first blood sample obtained after cohort engagement.



54 cases and 93 controls were included. Median F2-IsoPs and MDA levels were significantly higher in cases than in controls. When adjustment was performed for age, HIV-transmission category, CD4 cell count and HIV viral load at cohort entry, and subclinical inflammation measured with highly-sensitive C-reactive protein (hsCRP), the association of F2-IsoPs with mortality remained significant (adjusted OR per 1 log10 increase, 2.34 [1.23-4.47], P = 0.009). The association of MDA with mortality was attenuated after adjustment: adjusted OR (95% CI) per 1 log10 increase, 2.05 [0.91-4.59], P = 0.080. Median hsCRP was also higher in cases, and it also proved to be an independent predictor of mortality in the adjusted analysis: OR (95% CI) per 1 log10 increase, 1.39 (1.01-1.91), P = 0.043; and OR (95% CI) per 1 log10 increase, 1.46 (1.07-1.99), P = 0.014, respectively, when adjustment included F2-IsoPs and MDA.



Oxidative stress is a predictor of all-cause mortality in HIV-infected patients. For plasma F2-IsoPs, this association is independent of HIV-related factors and subclinical inflammation.
Infectious Diseases Unit, Hospital General de Elche, Universidad Miguel Hernández, Alicante, Spain.
Mar
M
Masiá
Infectious Diseases Unit, Hospital General de Elche, Universidad Miguel Hernández, Alicante, Spain.
Sergio
S
Padilla
Infectious Diseases Research Laboratory, Hospital General de Elche, Alicante, Spain.
Marta
M
Fernández
HIV/AIDS and Sexually Transmitted Diseases Clinic, Centro Sanitario Sandoval, Madrid, Spain.
Carmen
C
Rodríguez
Infectious Diseases Service, Hospital Ramón y Cajal, Instituto Ramón y Cajal de Investigación Sanitaria, Madrid, Spain.
Ana
A
Moreno
Infectious Diseases Service, Hospital San Pedro de La Rioja, Logroño, Spain.
Jose A
JA
Oteo
Infectious Diseases Unit, Hospital Clínico de Santiago, La Coruña, Spain.
Antonio
A
Antela
Infectious Diseases Service, Hospital Ramón y Cajal, Instituto Ramón y Cajal de Investigación Sanitaria, Madrid, Spain.
Santiago
S
Moreno
Centro Nacional de Epidemiología, Instituto de Salud Carlos III, Madrid, Spain.
Julia
J
Del Amo
Infectious Diseases Unit, Hospital General de Elche, Universidad Miguel Hernández, Alicante, Spain.
Félix
F
Gutiérrez
D000328:Adult; D016022:Case-Control Studies; D002423:Cause of Death; D028441:F2-Isoprostanes / Q000097:blood; D005260:Female; D015658:HIV Infections / Q000378:metabolism / Q000401:mortality*; D006801:Humans; D008297:Male; D008315:Malondialdehyde / Q000097:blood; D008875:Middle Aged; D018384:Oxidative Stress
D028441:F2-Isoprostanes; D008315:Malondialdehyde