Abstract

Combined antiretroviral therapy (cART) controls viral replication in HIV infection. However, HIV-infected patients are still at higher risk of comorbidities compared to general population, partially explained by persistent elevated levels of inflammation and immune activation.

Methods: In this longitudinal observational study, we assessed changes in immune activation and inflammation markers (interleukin-6 (IL-6), interferon-γ-inducible protein-10 (IP-10), monokine induced by interferon-γ (MIG) and soluble CD14 (sCD14)) levels during two years of effective first-line cART. Biomarker levels before and after cART were compared to those observed in healthy subjects. Elevated biomarker levels were defined with respect to healthy subjects values (mean + 2SD). Factors associated with persistently elevated biomarker levels after 2 years of cART were identified by logistic regression.

Results: We studied 139 patients with a median HIV-1 RNA level of 4.8 log₁₀ copies/mL and a median CD4 cell count of 294/mm³ at cART initiation (D0). At D0, all biomarker levels were higher than in healthy subjects (p<0.05). After 2 years of cART, IL-6, IP-10 and MIG levels fell significantly (all p<0.001), and were no longer elevated in >75% of patients. In contrast, sCD14 levels did not change significantly (p=0.102) and remained elevated. Older age was associated with elevated levels of IP-10 (OR, 1.60/10-year; p=0.047) and MIG (OR, 1.92/10-year; p=0.007) after 2 years of cART.

Conclusions: Rapid and persistent viral suppression by first-line cART reduces IL-6, IP-10 and MIG to normal levels while sCD14, a marker of monocyte activation and microbial translocation remain elevated. High levels of immune activation tend to persist in older patients.

عنوان المؤتمر

5 th PFMR Biomedical Research Symposium

دولة المؤتمر

فلسطين

تاريخ المؤتمر

4 إبريل، 2015 - 4 إبريل، 2015

راعي المؤتمر

non

معلومات إضافية

موقع المؤتمر الإلكتروني