Changes in Metabolic, Inflammatory and Coagulation Biomarkers after HIV Seroconversion – the Health in Men (Him) Biomarker Substudy

Achhra, Amit C.; Amin, Janaki; Law, Matthew; Grulich, Andrew E.; Yeung, Julie; Kelleher, Anthony D.; Cooper, David A.

doi:10.3851/imp2434

Cited by 3 publications

(2 citation statements)

References 18 publications

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“…Fourth, we did not measure other known biomarkers such as high sensitivity CRP, fibrinogen, D-dimer, and interleukin 6, and so could not determine their association with biomarkers of endothelial activation in this population. However, these four biomarkers were not found to be elevated after HIV-1 acquisition in a cohort of male seroconverters [34]. Finally, because we studied a group of Kenyan women who had seroconverted for HIV-1 infection, our results may not be generalizable to men, to persons in other geographic locations, or to persons who are treated with ART early in the course of infection.…”

Section: Discussionmentioning

confidence: 97%

Endothelial activation biomarkers increase after HIV-1 acquisition

Graham

Rajwans

Jaoko

et al. 2013

Aids

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Objective We aimed to determine whether endothelial activation biomarkers increase after HIV-1 acquisition, and whether biomarker levels measured in chronic infection would predict disease progression and death in HIV-1 seroconverters. Design HIV-1-seronegative Kenyan women were monitored monthly for seroconversion, and followed prospectively after HIV-1 acquisition. Methods Plasma levels of angiopoietins-1 and -2 (ANG-1, ANG-2) and soluble vascular cell adhesion marker-1 (VCAM-1), intercellular adhesion marker-1 (ICAM-1), and E-selectin were tested in stored samples from before infection, acute infection, and at two points during chronic infection. We used non-parametric tests to compare biomarkers before and after HIV-1 acquisition, and Cox proportional-hazards regression to analyze associations with disease progression (CD4 <200 cells/μL, Stage IV disease, or ART initiation) or death. Results Soluble ICAM-1 and VCAM-1 were elevated relative to baseline in all post-infection periods assessed (p<0.0001). Soluble E-selectin and the ANG-2:ANG-1 ratio increased in acute infection (p=0.0001), and ANG-1 decreased in chronic infection (p=0.0004). Among 228 subjects followed over 1,028 person-years, 115 experienced disease progression or death. Plasma VCAM-1 levels measured during chronic infection were independently associated with time to HIV progression or death (aHR 5.36, 95% confidence interval 1.99–14.44 per log10 increase), after adjustment for set point plasma viral load, age at infection, and soluble ICAM-1 levels. Conclusions HIV-1 acquisition was associated with endothelial activation, with sustained elevations of soluble ICAM-1 and VCAM-1 post-infection. Soluble VCAM-1 may be an informative biomarker for predicting the risk of HIV-1 disease progression, morbidity, and mortality.

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Section: Discussionmentioning

confidence: 97%

Endothelial activation biomarkers increase after HIV-1 acquisition

Graham

Rajwans

Jaoko

et al. 2013

Aids

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“…1): the date closest to but before the date of the last negative HIV antibody test (pre-HIV infection), 2) the date closest to but before the date of first ART prescription (pre-ART), 3) the date closest to but after the date of first ART prescription with evidence of HIV-1 RNA reduction (HIV-1 RNA <500 copies/mL; post-ART). These specific time points were selected to enable comparison to prior work [11]. For all participants who seroconverted but did not initiate ART, the pre-ART date was the date of last follow up in the VA health care system.…”

Section: Methodsmentioning

confidence: 99%

HIV Infection, Antiretroviral Therapy Initiation and Longitudinal Changes in Biomarkers of Organ Function

So‐Armah¹,

Chang²,

Alcorn³

et al. 2014

CHR

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Background HIV is associated with end-organ diseases of aging via unclear mechanisms. Longitudinally assessing how HIV infection and ART initiation affect biomarkers of end organ function/disease could clarify these mechanisms. We investigated longitudinal changes in clinical biomarkers following 1) HIV infection and 2) ART initiation with evidence of viral suppression. Methods Cohort: Veterans Aging Cohort Study Virtual Cohort (VACS VC). VACS VC is a longitudinal cohort of HIV infected (HIV+) and race-ethnicity, sex, age, and clinical site-matched uninfected Veterans enrolled in the same calendar year. Inclusion criteria: a negative and successively positive (>six months) HIV antibody test. We used Wilcoxon signed-rank tests to analyze 1) the effect of HIV infection on lipids, renal, hepatic and hematologic/cardiovascular biomarkers and 2)whether ART initiation with HIV-1 RNA<500 cpm reverts any changes back to pre-HIV levels Results 422 Veterans had at least 1 biomarker measurement available prior to HIV infection and prior to ART initiation. 297 had at least 1 biomarker measurement available prior to HIV infection and after ART initiation with evidence of viral suppression. Mean age prior to HIV infection was 43 years. HIV infection was associated with reduction in total cholesterol, HDL cholesterol, LDL cholesterol, serum albumin, ALT, platelet count, hemoglobin and elevation of FIB-4 score and triglycerides. These changes occurred without significant changes in BMI. ART initiation (with HIV-1 RNA<500cpm) did not reverse alteration in triglycerides, LDL cholesterol, hemoglobin, or FIB-4 to pre-HIV infection levels. Conclusions HIV infection is associated with longitudinal changes in serum levels of several biomarkers of end-organ function/disease and mortality. Multiple biomarkers (triglycerides, LDL cholesterol, hemoglobin, and FIB-4) remain altered from levels prior to HIV infection levels even following inititiation of ART and evidence of viral suppression. These results give insights into underlying mechanisms of increased risk for aging-related chronic diseases in the context of HIV infection.

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Update on metabolic issues in HIV patients

Calvo

Martínez

2014

Current Opinion in HIV and AIDS

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Inflammation, cholesterol abnormalities, and lipodystrophy caused by both HIV infection and antiretroviral therapy may pose aging HIV-infected patients at a higher risk of comorbidities and frailty despite sustained viral suppression. Healthier lifestyles and strategies specifically addressed to diminish the impact of these pathophysiologic abnormalities will be needed for preserving the overall health in aging HIV-infected persons.

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Changes in Metabolic, Inflammatory and Coagulation Biomarkers after HIV Seroconversion – the Health in Men (Him) Biomarker Substudy

Cited by 3 publications

References 18 publications

Endothelial activation biomarkers increase after HIV-1 acquisition

Endothelial activation biomarkers increase after HIV-1 acquisition

HIV Infection, Antiretroviral Therapy Initiation and Longitudinal Changes in Biomarkers of Organ Function

Update on metabolic issues in HIV patients

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