C-Reactive Protein Is a Marker for Human Immunodeficiency Virus Disease Progression

Lau, Bryan; Sharrett, A. Richey; Kingsley, Lawrence A.; Post, Wendy S.; Palella, Frank J.; Visscher, Barbara R.; Gange, Stephen J.

doi:10.1001/archinte.166.1.64

Cited by 191 publications

(160 citation statements)

References 20 publications

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“…63,64 The Multicenter AIDS Cohort Study (MACS) showed an elevated CRP level in HIV-positive patients that was associated with AIDS, negatively correlated with CD4 cell count and positively correlated with HIV RNA levels. 65 Higher D-dimer levels were also associated with increased CVD risk in the general population. 66 In the SMART study, 1 month after stopping treatment, HIV RNA levels were associated with increases in D-dimer and IL-6 levels, and baseline D-dimer and IL-6 levels were strongly associated with an increased risk of all-cause mortality.…”

Section: Hiv Infectionmentioning

confidence: 99%

HIV infection, aging and cardiovascular disease: epidemiology and prevention

Petoumenos

Worm

2011

Sex. Health

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Abstract. In the developed world, HIV infection is now well managed with very effective and less toxic antiretroviral treatment. HIV-positive patients therefore are living longer, but are now faced by challenges associated with aging. Several non-AIDS associated morbidities are increased in this population, including cardiovascular disease (CVD). It is suggested that CVD occurs earlier among HIV-positive patients compared with HIV-negative patients, and at a higher rate. Several factors have been proposed to contribute to this. First, the traditional CVD risk factors are highly prevalent in this population. High rates of smoking, dyslipidaemia and a family history of CVD have been reported. This population is also aging, with estimates of more than 25% of HIV-positive patients in the developed world being over the age of 50. Antiretroviral treatment, both through its effect on lipids and through other, sometimes less well understood, mechanisms, has been linked to increased CVD risk. HIV infection, especially untreated, is a further contributing factor to increased CVD risk in HIV-positive patients. As the HIV-positive population continues to age, the risk of CVD will continue to increase. Guidelines for the management and prevention of CVD risk have been developed, and are largely modelled on those used in the general population. However, the data currently suggest that these interventions, such as the use of lipid-lowering medications and smoking cessation programs, remain quite low. A better understanding the mechanisms of CVD risk in this aging population and further efforts in improving uptake of prevention strategies will remain an important research area.

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Section: Hiv Infectionmentioning

confidence: 99%

HIV infection, aging and cardiovascular disease: epidemiology and prevention

Petoumenos

Worm

2011

Sex. Health

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“…Studies have shown a significant relationship between the CD4 cell count, serum cortisol, and DHEA levels (2,3). There are reports on the association of high levels of plasma highly sensitive C-reactive protein (CRP) and HIV disease progression (5,9). The present study was carried out to investigate if plasma levels of either DHEAS, albumin, or CRP could be used as an alternate prognostic marker(s) of ART response in place of viral-load measurement in HIV-infected individuals in south India.…”

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confidence: 99%

Usefulness of Alternate Prognostic Serum and Plasma Markers for Antiretroviral Therapy for Human Immunodeficiency Virus Type 1 Infection

Kannangai¹,

Kandathil²,

Ebenezer³

et al. 2008

Clin Vaccine Immunol

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In developing countries, the usability of peripheral blood constituents that are low-cost alternatives to CD4-positive (CD4 ؉ ) T-cell and human immunodeficiency virus type 1 (HIV-1) RNA estimation should be evaluated as prognostic markers. The aim of our study was to investigate the use of plasma levels of dehydroepiandrosterone sulfate (DHEAS), albumin, and C-reactive protein (CRP) as alternate prognostic markers for antiretroviral treatment (ART) response in place of HIV-1 load measurements. Paired blood samples were collected from 30 HIV-infected individuals before and after initiation of ART, 13 HIV-infected individuals before and after completion of antituberculosis therapy (ATT), and 10 HIV-infected individuals not on either ATT or ART. Because of the nonavailability of samples, the CRP estimation was done for samples from only 19, 9, and 8 individuals in groups 1, 2, and 3, respectively. The measurements of all three markers, i.e., DHEAS, albumin, and CRP, were carried out with commercial assays. The differences in the albumin levels before and after ART or ATT were significant (P < 0.05), while the differences in DHEAS and CRP levels were not significant (P > 0.05). When levels of DHEAS among the individuals who were followed up were analyzed, 13 (44.8%) in the ART group and 9 (69%) in the ATT group showed an increase following treatment. Prior to treatment of HIV-infected individuals, there was a significant positive correlation of CD4 ؉ T-cell counts and a negative correlation of viral load with albumin and DHEAS levels (P < 0.01). Among the three plasma markers we tested, plasma albumin and, to some extent, DHEAS show promise as prognostic markers in monitoring HIV infection.Morbidity and mortality due to human immunodeficiency virus (HIV) continue to be major problems in developing countries (8). Currently, the availability and affordability of antiretroviral treatment (ART) are improving in these countries (21). Though CD4-positive (CD4 ϩ ) T-cell estimation and the plasma HIV-1 load continue to be the major prognostic markers of progression, several other peripheral blood constituents may be considered for roles as prognostic markers (1,4,20). The serum albumin level is considered one of these alternatives, as it has been shown that a low level of serum albumin, i.e., Ͻ3.5 mg/ml, after seroconversion is associated with faster HIV disease progression (14). Studies have shown a significant relationship between the CD4 cell count, serum cortisol, and DHEA levels (2, 3). There are reports on the association of high levels of plasma highly sensitive C-reactive protein (CRP) and HIV disease progression (5, 9). The present study was carried out to investigate if plasma levels of either DHEAS, albumin, or CRP could be used as an alternate prognostic marker(s) of ART response in place of viral-load measurement in HIV-infected individuals in south India. MATERIALS AND METHODSThe study was carried out in the Department of Clinical Virology, Christian Medical College (CMC) Hospital, Vellore, India, a tertiary...

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“…As previously stated, the HIV Metabolic Clinic is an outpatient medical service that actively treats metabolic disorders in healthy and virallysuppressed HIV-positive patients. The effect of antiretroviral therapy on viral suppression may have decreased serum CRP and obscured our ability to detect an association of CRP and an abnormal carotid ultrasound [34,39,40].…”

Section: Discussionmentioning

confidence: 99%

High Prevalence of Carotid Plaque Identified Using Standard Carotid Ultrasound Techniques in HIV-Positive Patients with Low to Moderate Vascular Risk

Stanek¹

2014

J AIDS Clin Res

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C-Reactive Protein Is a Marker for Human Immunodeficiency Virus Disease Progression

Cited by 191 publications

References 20 publications

HIV infection, aging and cardiovascular disease: epidemiology and prevention

HIV infection, aging and cardiovascular disease: epidemiology and prevention

Usefulness of Alternate Prognostic Serum and Plasma Markers for Antiretroviral Therapy for Human Immunodeficiency Virus Type 1 Infection

High Prevalence of Carotid Plaque Identified Using Standard Carotid Ultrasound Techniques in HIV-Positive Patients with Low to Moderate Vascular Risk

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