All About the Albumin? Prognostic Capacity of Serum Albumin in Patients With Treated HIV Infection.
All About the Albumin? Prognostic Capacity of Serum Albumin in Patients With Treated HIV Infection.
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关于白蛋白的一切？
DOI：
10.1093/infdis/jix463
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发表时间：
2018
期刊：
影响因子：
--
通讯作者：
Hunt,PeterW
中科院分区：
文献类型：
--
作者：
Siedner,MarkJ;Hunt,PeterW
While immediate as compared to delayed initiation of antiretroviral therapy (ART) was shown to decrease morbidity in individuals with early stage human immunodeficiency virus (HIV) infection in 2 large randomized controlled trials, even those who initiate ART at high CD4+ T-cell counts appear to be at increased risk of infectious and neoplastic complications, compared with the general population [1, 2]. As the HIV epidemic ages globally, other age-associated morbidities may also become more prevalent in the treated population. Since the HIV-associated inflammatory state persists despite ART-mediated viral suppression—even among those who initiate ART at the earliest stages [3]—and strongly predicts many of these morbidities [4], a major research effort is underway to develop immune-based interventions to further improve health in this setting. As not all HIV-infected individuals have persistently high levels of immune activation and, thus, may be at low risk of morbidity [5], the field will eventually need biomarkers to stratify individuals at the greatest risk of disease, once safe and scalable immune-based therapies are shown to reduce morbidity and mortality in this population. For example, while the recently published findings from the Canakinumab Antiinflammatory Thrombosis Outcomes Study have proven for the first time that a pure antiinflammatory intervention (in this case, an interleukin 1β inhibitor) reduces the risk of death from cardiovascular and neoplastic causes in HIV-uninfected individuals with cardiovascular disease [6], ongoing studies will need to determine whether this strategy can safely be used in the context of treated HIV infection. Even if proven safe in the context of HIV, such a strategy would only be used for those at the highest risk of disease. Statins are also now being tested in a large clinical outcomes trial in treated HIV infection to see if its antiinflammatory properties reduce cardiovascular and other non-AIDS morbidities, but even a safer intervention like this would only be given to those at highest risk, particularly in resource-constrained settings. Thus, it is likely that biomarkers that can stratify individuals with treated HIV infection according to morbidity risk will be needed in the future for the provision of antiinflammatory interventions. Since the majority of HIV-infected individuals around the world live in resource-limited settings, it will also be important for such biomarkers to be measured easily and at low cost.
DOI：
10.1056/nejmoa1506816
发表时间：
2015-08-27
期刊：
The New England journal of medicine
影响因子：
--
作者：
INSIGHT START Study Group;Lundgren JD;Babiker AG;Gordin F;Emery S;Grund B;Sharma S;Avihingsanon A;Cooper DA;Fätkenheuer G;Llibre JM;Molina JM;Munderi P;Schechter M;Wood R;Klingman KL;Collins S;Lane HC;Phillips AN;Neaton JD
通讯作者：
Neaton JD
影响因子：
11.8
作者：
Sereti, Irini;Krebs, Shelly J.;Utay, Netanya S.
通讯作者：
Utay, Netanya S.