Activation, senescence and inflammation markers in HIV patients: association with renal function.
To assess the association among immune activation, immune senescence, inflammation biomarkers and renal function measured by estimated glomerular filtration rate (eGFR) at inclusion and its evolution over a 3-year follow-up in HIV-infected patients with undetectable viral load.



The Chronic Immune Activation and Senescence (CIADIS) substudy consecutively included patients between October 2011 and May 2013 enrolled in the ANRS CO3 Aquitaine observational cohort.



Biomarkers of T-cell activation, differentiation and senescence were summarized in a cellular-CIADIS weighted score and inflammation biomarkers in a soluble-CIADIS weighted score using principal component analysis. Logistic regression and linear mixed models were used to determine the association between the CIADIS weighted scores and confirmed eGFR less than 60 ml/min per 1.73 m, and evolution of eGFR, respectively.



Of 756 patients with an undetectable viral load, 76% were men, and median age was 51 years (Interquartile range: 45-57 years). In multivariable analysis, the soluble-CIADIS weighted score was independently associated with a confirmed eGFR less than 60 [odds ratio = 1.4; 95% confidence interval (CI) 1.1-1.8] but the cellular-CIADIS weighted score was not (odds ratio = 1.2; 95% CI 1.0-1.5). Only in patients with a confirmed eGFR less than 60 ml/min per 1.73 m at inclusion, a higher soluble-CIADIS weighted score (increased inflammation) was associated with a steeper decrease of renal function of -2.3 (ml/min per 1.73 m) per year (95% CI -3.6 to -1.0).



At inclusion, soluble-CIADIS weighted score was independently associated with a confirmed eGFR less than 60 ml/min per 1.73 m. The soluble-CIADIS weighted score was associated with a decrease of eGFR evolution during a 3-year follow-up only in patients with a confirmed eGFR less than 60 ml/min per 1.73 m.
aUniversity Bordeaux, ISPED, Inserm, Bordeaux Population Health Research Center, Team MORPH3EUS, UMR 1219, CIC-EC 1401 bCNRS-UMR 5164 Immuno ConcEpT, Bordeaux University and Bordeaux Hospital cCHU de Bordeaux, Service de médecine interne et immunologie clinique dCHU de Bordeaux, Service de Maladies infectieuses et Tropicales eCHU de Bordeaux, Service de néphrologie, transplantation et dialyse fCHU de Bordeaux, Laboratoire d'Immunologie et Immunogénétique, University Bordeaux, Bordeaux gCHU de Bordeaux, Service de Médecine Interne, Hôpital Haut-Lévêque, Pessac hCHU de Bordeaux, Pôle de santé publique iCHU de Bordeaux, service de Médecine Interne et Maladies Infectieuses, Bordeaux, France. *Alexandra Ozanne, Pierre Duffau, Linda Wittkop and Isabelle Pellegrin contributed equally to the article.
Alexandra
A
Ozanne
Pierre
P
Duffau
Frédéric-Antoine
FA
Dauchy
Claire
C
Rigothier
Cécile
C
Terrien
Estibaliz
E
Lazaro
Charles
C
Cazanave
Sylvie
S
Lawson-Ayayi
Fabrice
F
Bonnet
Patrick
P
Blanco
Linda
L
Wittkop
Isabelle
I
Pellegrin
D016263:AIDS-Associated Nephropathy / Q000473:pathology*; D000368:Aged; D000375:Aging; D005260:Female; D005919:Glomerular Filtration Rate; D015658:HIV Infections / Q000150:complications* / Q000188:drug therapy / Q000473:pathology*; D006801:Humans; D007249:Inflammation / Q000473:pathology*; D008213:Lymphocyte Activation; D008297:Male; D008875:Middle Aged; D011446:Prospective Studies; D011795:Surveys and Questionnaires; D000072230:Sustained Virologic Response