Changes in inflammation but not in T-Cell activation precede non-AIDS-defining events in a case-control study of patients on long-term antiretroviral therapy

Konstantia Angelidou, Peter W. Hunt, Alan L. Landay, Cara C. Wilson, Benigno Rodriguez, Steven G. Deeks, Ronald J. Bosch, Michael M. Lederman

Research output: Contribution to journalArticlepeer-review

30 Scopus citations

Abstract

Background We examined changes in soluble inflammatory cytokines and T-cell activation after antiretroviral therapy (ART) initiation in an AIDS Clinical Trials Group (ACTG) nested case-control study. Methods Cases were 143 human immunodeficiency virus (HIV)-infected adults who developed a non-AIDS event; 315 controls remained event-free. Specimens were tested pre-ART, year 1 post-ART, and at the visit preceding the event. Conditional logistic regression evaluated the associations of biomarker changes with non-AIDS events. Results Inflammatory and most activation biomarkers declined from pre-ART to year 1 for cases and controls. Subsequently, inflammatory biomarkers remained mostly stable in controls but not cases. Cellular activation markers generally declined for both cases and controls between year 1 and the pre-event sampling. Controls with greater pre-ART RNA levels or lower CD4 + levels had higher biomarker levels while also experiencing greater biomarker declines in the first year of ART. Changes in biomarkers to year 1 showed no significant associations with non-AIDS events. Cases, however, had significantly greater increases in all plasma biomarkers (but not cellular activation) from year 1 to the visit preceding the event. Conclusions Inflammation increases prior to non-AIDS events in treated HIV-infected adults. These biomarker changes may reflect subclinical disease processes or other alterations in the inflammatory environment that causally contribute to disease. Clinical Trials Registration NCT00001137.

Original languageEnglish (US)
Pages (from-to)239-248
Number of pages10
JournalJournal of Infectious Diseases
Volume218
Issue number2
DOIs
StatePublished - Jun 20 2018
Externally publishedYes

Keywords

  • antiretroviral therapy
  • HIV
  • inflammation
  • non-AIDS morbidity
  • T-cell activation

ASJC Scopus subject areas

  • Immunology and Allergy
  • Infectious Diseases

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