Timing of Antiretroviral Therapy and Systemic Inflammation in Sub-Saharan Africa: Results from the META Longitudinal Cohort Study

Mark J. Siedner; Mwebesa Bosco Bwana; Stephen Asiimwe; Gideon Amanyire; Nicholas Musinguzi; Jose Castillo-Mancilla; Russell P. Tracy; Ingrid T. Katz; David R. Bangsberg; Peter W. Hunt; Catherine Orrell; Jessica E. Haberer; Norma Ware; Tumwesigye Elioda; Alexander C. Tsai; Lynn Matthews; Monique Wyatt

doi:10.1093/infdis/jiz259

Timing of Antiretroviral Therapy and Systemic Inflammation in Sub-Saharan Africa: Results from the META Longitudinal Cohort Study

Mark J. Siedner, Mwebesa Bosco Bwana, Stephen Asiimwe, Gideon Amanyire, Nicholas Musinguzi, Jose Castillo-Mancilla, Russell P. Tracy, Ingrid T. Katz, David R. Bangsberg, Peter W. Hunt, Catherine Orrell, Jessica E. Haberer, Norma Ware, Tumwesigye Elioda, Alexander C. Tsai, Lynn Matthews, Monique Wyatt

School Of Public Health

Research output: Contribution to journal › Article › peer-review

7 Scopus citations

Abstract

Chronic inflammation predicts complications in persons with human immunodeficiency virus infection. We compared D-dimer, soluble CD14, and interleukin 6 levels before and 12 months after antiretroviral therapy (ART) initiation, among individuals starting ART during earlier-stage (CD4 T-cell count >350/μL) or late-stage disease (CD4 T-cell count <200/μL). Female sex, older age, viral load, and late-stage disease were associated with pre-ART biomarkers (n = 661; P <. 05). However, there were no differences in biomarkers by disease stage after 12 months of ART (n = 438; P >. 05), owing to loss from observation and greater declines in biomarkers in late-stage initiators (P <. 001). Earlier initiation of ART is associated with decreased inflammation, but levels seem to converge between earlier and later initiators surviving to 12 months.

Original language	English (US)
Pages (from-to)	1172-1177
Number of pages	6
Journal	Journal of Infectious Diseases
Volume	220
Issue number	7
DOIs	https://doi.org/10.1093/infdis/jiz259
State	Published - Aug 30 2019

Keywords

HIV
South Africa
Uganda
antiretroviral therapy
immune activation
inflammation

ASJC Scopus subject areas

Immunology and Allergy
Infectious Diseases

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10.1093/infdis/jiz259

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Siedner, M. J., Bwana, M. B., Asiimwe, S., Amanyire, G., Musinguzi, N., Castillo-Mancilla, J., Tracy, R. P., Katz, I. T., Bangsberg, D. R., Hunt, P. W., Orrell, C., Haberer, J. E., Ware, N., Elioda, T., Tsai, A. C., Matthews, L., & Wyatt, M. (2019). Timing of Antiretroviral Therapy and Systemic Inflammation in Sub-Saharan Africa: Results from the META Longitudinal Cohort Study. Journal of Infectious Diseases, 220(7), 1172-1177. https://doi.org/10.1093/infdis/jiz259

Siedner, MJ, Bwana, MB, Asiimwe, S, Amanyire, G, Musinguzi, N, Castillo-Mancilla, J, Tracy, RP, Katz, IT, Bangsberg, DR, Hunt, PW, Orrell, C, Haberer, JE, Ware, N, Elioda, T, Tsai, AC, Matthews, L & Wyatt, M 2019, 'Timing of Antiretroviral Therapy and Systemic Inflammation in Sub-Saharan Africa: Results from the META Longitudinal Cohort Study', Journal of Infectious Diseases, vol. 220, no. 7, pp. 1172-1177. https://doi.org/10.1093/infdis/jiz259

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abstract = "Chronic inflammation predicts complications in persons with human immunodeficiency virus infection. We compared D-dimer, soluble CD14, and interleukin 6 levels before and 12 months after antiretroviral therapy (ART) initiation, among individuals starting ART during earlier-stage (CD4 T-cell count >350/μL) or late-stage disease (CD4 T-cell count <200/μL). Female sex, older age, viral load, and late-stage disease were associated with pre-ART biomarkers (n = 661; P <. 05). However, there were no differences in biomarkers by disease stage after 12 months of ART (n = 438; P >. 05), owing to loss from observation and greater declines in biomarkers in late-stage initiators (P <. 001). Earlier initiation of ART is associated with decreased inflammation, but levels seem to converge between earlier and later initiators surviving to 12 months.",

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AU - Asiimwe, Stephen

AU - Amanyire, Gideon

AU - Musinguzi, Nicholas

AU - Castillo-Mancilla, Jose

AU - Tracy, Russell P.

AU - Katz, Ingrid T.

AU - Bangsberg, David R.

AU - Hunt, Peter W.

AU - Orrell, Catherine

AU - Haberer, Jessica E.

AU - Ware, Norma

AU - Elioda, Tumwesigye

AU - Tsai, Alexander C.

AU - Matthews, Lynn

AU - Wyatt, Monique

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AB - Chronic inflammation predicts complications in persons with human immunodeficiency virus infection. We compared D-dimer, soluble CD14, and interleukin 6 levels before and 12 months after antiretroviral therapy (ART) initiation, among individuals starting ART during earlier-stage (CD4 T-cell count >350/μL) or late-stage disease (CD4 T-cell count <200/μL). Female sex, older age, viral load, and late-stage disease were associated with pre-ART biomarkers (n = 661; P <. 05). However, there were no differences in biomarkers by disease stage after 12 months of ART (n = 438; P >. 05), owing to loss from observation and greater declines in biomarkers in late-stage initiators (P <. 001). Earlier initiation of ART is associated with decreased inflammation, but levels seem to converge between earlier and later initiators surviving to 12 months.

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Timing of Antiretroviral Therapy and Systemic Inflammation in Sub-Saharan Africa: Results from the META Longitudinal Cohort Study

Abstract

Keywords

ASJC Scopus subject areas

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