Immunologic Biomarkers, Morbidity, and Mortality in Treated HIV Infection.
Despite marked improvements in the modern treatment era, human immunodeficiency virus (HIV)-infected individuals, particularly those who initiated antiretroviral therapy (ART) at advanced disease stages, continue to have increased age-related morbidity and mortality, compared with the general population. Immune activation and inflammation persist despite suppressive ART and predict many of these morbidities. The goal of this review is to examine the evidence suggesting a link between the persistent inflammatory state and morbidity and mortality in this setting, to describe the impact of early ART initiation on these factors, and to highlight important unanswered questions for the field. We also advance a hypothesis to explain why some morbidities-and their root inflammatory drivers-may be prevented more than others by early ART initiation.
Department of Medicine, University of California-San Francisco.
Peter W
PW
Hunt
Department of Medicine, University of California-San Francisco.
Sulggi A
SA
Lee
Department of Medicine, Massachusetts General Hospital and Harvard Medical School, Boston.
Mark J
MJ
Siedner
D019380:Anti-HIV Agents / Q000627:therapeutic use*; D023241:Antiretroviral Therapy, Highly Active; D015415:Biomarkers; D002986:Clinical Trials as Topic; D060085:Coinfection; D015658:HIV Infections / Q000188:drug therapy / Q000276:immunology* / Q000401:mortality*; D006801:Humans; D007113:Immunity, Innate; D007249:Inflammation / Q000276:immunology; D008019:Life Style
D019380:Anti-HIV Agents; D015415:Biomarkers
HIV-1 infection; antiretroviral therapy; biomarkers; immune activation; inflammation; morbidity; mortality