Long-term trajectories of C-reactive protein among men living with and without HIV infection in the Multicenter AIDS Cohort Study.
Long-term trajectories of C-reactive protein among men living with and without HIV infection in the Multicenter AIDS Cohort Study.
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DOI：
10.1093/gerona/glab190
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发表时间：
2021-07
期刊：
影响因子：
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通讯作者：
N. Wada;E. Breen;W. Post;V. Stosor;B. Macatangay;J. Margolick
中科院分区：
文献类型：
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作者：
N. Wada;E. Breen;W. Post;V. Stosor;B. Macatangay;J. Margolick
c反应蛋白（CRP）是一种与全因死亡率和发病率（如心血管疾病）相关的炎症生物标志物。CRP随着HIV感染而增加，并被认为随着年龄的增长而增加，尽管CRP随年龄增长的轨迹尚未得到很好的表征。我们根据HIV感染和HIV病毒载量状况调查了多中心艾滋病队列研究中男性CRP的轨迹。方法从2132名男性在30年间提供的12250份血清样本中测量CRP，根据样本收集时的HIV状态进行分类：HIV未感染（HIV-, n=1,717）， HIV感染，HIV+，不可检测的RNA （HIV+抑制，n=4,075）和可检测的HIV RNA （HIV+可检测，n=6,458）。CRP的年龄相关轨迹拟合为多变量线性混合模型；我们测试了不同HIV状态的轨迹差异。结果CRP随年龄增长而升高。在20-70岁的观察年龄范围内，HIV阳性检测组和HIV阳性抑制组的CRP高于HIV阴性组（p<0.05）。45岁时的CRP浓度在HIV阳性检测样本和HIV阳性抑制样本中分别比HIV阴性样本高38% （95% CI: 26%-50%）和26%（15%-38%）。HIV阳性检测样本与HIV阳性样本相比，随着年龄的增长呈现出更快的线性增长（每十年增加8%，0.3%-16%）。结论：我们观察到，在50岁的男性HIV感染者中，CRP浓度较高，相对于HIV-男性，在可检测到HIV RNA的男性中，CRP浓度随年龄的增长而急剧上升。这些结果与炎症对HIV感染的年龄相关合并症的高风险的贡献是一致的。
BACKGROUND C-reactive protein (CRP) is an inflammatory biomarker associated with all-cause mortality and morbidities such as cardiovascular disease. CRP is increased with HIV infection and thought to increase with age, though trajectories of CRP with aging have not been well characterized. We investigated trajectories of CRP in men from the Multicenter AIDS Cohort Study, according to HIV infection and HIV viral load status. METHODS CRP measurements from 12,250 serum samples, provided by 2,132 men over a span of 30 years, were categorized by HIV status at sample collection: HIV-uninfected (HIV-, n=1,717), HIV-infected, HIV+, undetectable RNA (HIV+ suppressed, n=4,075), and detectable HIV RNA (HIV+ detectable, n=6,458). Age-related trajectories of CRP were fit to multivariable linear mixed models; we tested for differences in trajectories by HIV status. RESULTS CRP increased with age in all sample groups. HIV+ detectable and HIV+ suppressed samples had higher CRP than HIV- samples throughout the observed age range of 20-70 years (p<0.05). CRP concentrations at age 45 years were 38% (95% CI: 26%-50%) and 26% (15%-38%) higher in HIV+ detectable and HIV+ suppressed samples, respectively, relative to HIV- samples. HIV+ detectable samples showed more rapid linear increases with age (8% higher/decade, 0.3%-16%) than HIV- samples. CONCLUSIONS We observed higher concentrations of CRP across five decades of age in men living with HIV, and steeper increases with age in men with detectable HIV RNA, relative to HIV- men. These results are consistent with a contribution of inflammation to the higher risk of age-related comorbidities with HIV infection.