@article{90bd3deb4158451593743ea24f352284,
title = "Immunologic pathways that predict mortality in HIV-infected Ugandans initiating antiretroviral therapy",
abstract = "The plasma kynurenine/tryptophan (KT) ratio, a marker of adaptive immune defects, strongly predicts mortality during treated human immunodeficiency virus (HIV) disease in Ugandans as compared to US-based populations. Here, the KT ratio and T-cell and plasma biomarkers of immune activation were measured among 535 HIV-infected Ugandans prior to ART initiation and at month 6 of viral suppression. The month 6 KT ratio (adjusted hazard ratio [aHR], 2.74), soluble CD14 level (aHR, 2.32), interleukin 6 level (aHR, 2.34), and D-dimer level (aHR, 1.95) were associated with mortality occurring ≥6 months after ART initiation. The KT ratio remained significantly predictive of mortality even after adjustment for the additional biomarkers, suggesting an independent contribution to clinical outcomes in resource-limited settings.",
keywords = "Africa, Antiretroviral therapy, D-dimer, HIV, IL-6, Kynurenine, Mortality, Tryptophan, sCD14",
author = "Sulggi Lee and Helen Byakwaga and Yap Boum and Burdo, {Tricia H.} and Williams, {Kenneth C.} and Lederman, {Michael M.} and Yong Huang and Tracy, {Russell P.} and Huyen Cao and Haberer, {Jessica E.} and Annet Kembabazi and Bangsberg, {David R.} and Martin, {Jeffrey N.} and Hunt, {Peter W.}",
note = "Funding Information: Financial support. This work was supported by the National Institutes of Health (grants R56AI100765, R21AI087035, R01AI087145, R01MH054907, P01AI076174, K23GM112526, and P30AI036219), the University of California–San Francisco (UCSF)/Gladstone Institute of Virology and Immunology Center for AIDS Research (grant P30AI027763), the UCSF Clinical and Translational Research Institute Clinical Research Center (grant UL1RR024131), the Center for AIDS Prevention Studies (grant P30MH62246), and the AIDS Cancer Specimen Resource (grant UM1 CA181255). Publisher Copyright: {\textcopyright} The Author 2017. Published by Oxford University Press for the Infectious Diseases Society of America. All rights reserved.",
year = "2017",
month = apr,
day = "15",
doi = "10.1093/infdis/jix113",
language = "English (US)",
volume = "215",
pages = "1270--1274",
journal = "Journal of Infectious Diseases",
issn = "0022-1899",
publisher = "Oxford University Press",
number = "8",
}