Associations of inflammatory markers with AIDS and non-AIDS clinical events after initiation of antiretroviral therapy: AIDS clinical trials group A5224s, a substudy of ACTG A5202.
Associations of inflammatory markers with AIDS and non-AIDS clinical events after initiation of antiretroviral therapy: AIDS clinical trials group A5224s, a substudy of ACTG A5202.
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DOI：
10.1097/01.qai.0000437171.00504.41
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发表时间：
2014-02-01
期刊：
影响因子：
--
通讯作者：
Daar ES
中科院分区：
文献类型：
--
作者：
McComsey GA;Kitch D;Sax PE;Tierney C;Jahed NC;Melbourne K;Ha B;Brown TT;Bloom A;Fedarko N;Daar ES
抗逆转录病毒治疗(ART)开始后，炎性生物标志物与临床事件的相关性尚不清楚。A5202将1857名治疗初治的受试者随机分为阿巴卡韦/拉米夫定或替诺福韦-DF/恩曲他滨联合依沙韦仑或阿扎那韦/利托那韦。子研究A5224从基线和24周或96周测量了具有可用血浆的受试者的炎症生物标记物。采用COX比例风险模型对hsCRP、IL-6、sTNF-RI、sTNF-RII、TNF-α、sVCAM-1和sICAM-1与艾滋病发病时间和非艾滋病事件的关系进行了探索性分析。分析对象包括244名受试者，其中85%为男性，48%为非西班牙裔白人，中位年龄39岁，HIV1RNA4.6log10拷贝/毫升，CD4240细胞/μL。总体而言，发生了13起艾滋病事件(9例机会性感染；3例艾滋病癌症，1例复发细菌性肺炎)和18例非艾滋病事件(6例糖尿病，4例癌症，3例心血管疾病，5例肺炎)。较高的基线IL-6、sTNF-RI、sTNF-RII和sICAM-1与艾滋病定义事件的风险增加显著相关。对基线HIV-1RNA的调整没有改变结果，而根据基线CD4计数调整后，只剩下sTNF-RI和sICAM-1与风险增加显著相关。IL-6、sTNFR-I和II以及sICAM-1的时间更新值也与风险增加相关。对于非艾滋病事件，只有较高的基线hsCRP与增加的风险显著相关，而较高的IL-6与较高的风险略有关联。对时间更新的生物标志物数值的分析表明，即使在调整了抗逆转录病毒治疗和α计数或艾滋病毒-1RNA之后，肿瘤坏死因子-CD4值也与风险增加显著相关。几种炎性生物标志物水平较高独立地与艾滋病和非艾滋病事件的风险增加相关。
The association of inflammatory biomarkers with clinical events after antiretroviral therapy (ART) initiation is unclear. A5202 randomized 1857 treatment-naive subjects to abacavir/lamivudine or tenofovir-DF/emtricitabine with efavirenz or atazanavir/ritonavir. Substudy A5224s measured inflammatory biomarkers on subjects with available plasma from baseline and weeks 24 or 96. An exploratory analysis of the association of hsCRP, IL-6, sTNF-RI, sTNF-RII, TNF-α, sVCAM-1, and sICAM-1 with times to AIDS and to non-AIDS events used Cox proportional hazards models. Analysis included 244 subjects; 85% male, 48% white non-Hispanic, with median age 39 years, HIV-1 RNA 4.6 log10 copies/mL, and CD4 240 cells/μL. Overall, 13 AIDS events (9 opportunistic infections; 3 AIDS-cancers, 1 recurrent bacterial pneumonia) and 18 non-AIDS events (6 diabetes, 4 cancers, 3 cardiovascular, 5 pneumonias) occurred. Higher baseline IL-6, sTNF-RI, sTNF-RII, and sICAM-1 were significantly associated with increased risk of AIDS-defining events. Adjustment for baseline HIV-1 RNA did not change results, while adjusting for baseline CD4 count left only sTNF-RI and sICAM-1 significantly associated with increased risk. Time-updated values of IL-6, sTNFR-I and II, and sICAM-1 were also associated with an increased risk. For non-AIDS events, only higher baseline hsCRP was significantly associated with increased risk, while higher IL-6 was marginally associated with higher risk. Analyses of time-updated biomarker values showed TNF-α to be significantly associated with increased risk, even after adjustment for ART, and CD4 count or HIV-1 RNA. Higher levels of several inflammatory biomarkers were independently associated with increased risk of AIDS and non-AIDS events.
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影响因子：
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作者：
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