Timing of Antiretroviral Therapy and Systemic Inflammation in Sub-Saharan Africa: Results from the META Longitudinal Cohort Study

Mark J. Siedner, Mwebesa Bosco Bwana, Stephen Asiimwe, Gideon Amanyire, Nicholas Musinguzi, Jose Castillo-Mancilla, Russell P. Tracy, Ingrid T. Katz, David R. Bangsberg, Peter W. Hunt, Catherine Orrell, Jessica E. Haberer, Norma Ware, Tumwesigye Elioda, Alexander C. Tsai, Lynn Matthews, Monique Wyatt

Research output: Contribution to journalArticlepeer-review

4 Scopus citations

Abstract

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 late-stage 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.

Original languageEnglish (US)
Pages (from-to)1172-1177
Number of pages6
JournalJournal of Infectious Diseases
Volume220
Issue number7
DOIs
StatePublished - Aug 30 2019

Keywords

  • HIV
  • South Africa
  • Uganda
  • antiretroviral therapy
  • immune activation
  • inflammation

ASJC Scopus subject areas

  • Immunology and Allergy
  • Infectious Diseases

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