Timing of Antiretroviral Therapy and Systemic Inflammation in Sub-Saharan Africa: Results From the META Longitudinal Cohort Study
This work was supported by the Bill & Melinda Gates Foundation (grant OPP113634) and by National Institutes of Health (grant K23 MH099916).
The Journal of Infectious Diseases
Antiretroviral therapy -- Studies
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 latestage 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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Siedner, Mark J.; Bwana, Bosco M.; Asiimwe, Stephen; Amanyire, Gideon; Musinguzi, Nicholas; Castillo-Mancilla, Jose R.; Tracy, Russell P.; Katz, Ingrid T.; Bangsberg, David; and multiple additional authors, "Timing of Antiretroviral Therapy and Systemic Inflammation in Sub-Saharan Africa: Results From the META Longitudinal Cohort Study" (2019). OHSU-PSU School of Public Health Faculty Publications and Presentations. 221.
© The Author(s) 2019. Published by Oxford University Press for the Infectious Diseases Society of America. This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted reuse, distribution, and reproduction in any medium, provided the original work is properly cited. DOI: 10.1093/infdis/jiz259