التفاصيل البيبلوغرافية
| العنوان: |
Pre-cART Elevation of CRP and CD4+ T-Cell Immune Activation Associated With HIV Clinical Progression in a Multinational Case–Cohort Study |
| المؤلفون: |
Balagopal, Ashwin, Asmuth, David M, Yang, Wei-Teng, Campbell, Thomas B, Gupte, Nikhil, Smeaton, Laura, Kanyama, Cecilia, Grinsztejn, Beatriz, Santos, Breno, Supparatpinyo, Khuanchai, Badal-Faesen, Sharlaa, Lama, Javier R, Lalloo, Umesh G, Zulu, Fatima, Pawar, Jyoti S, Riviere, Cynthia, Kumarasamy, Nagalingeswaran, Hakim, James, Li, Xiao-Dong, Pollard, Richard B, Semba, Richard D, Thomas, David L, Bollinger, Robert C, Gupta, Amita |
| المصدر: |
JAIDS Journal of Acquired Immune Deficiency Syndromes, vol 70, iss 2 |
| بيانات النشر: |
eScholarship, University of California |
| سنة النشر: |
2015 |
| المجموعة: |
University of California: eScholarship |
| مصطلحات موضوعية: |
HIV/AIDS, Infectious Diseases, Prevention, Clinical Research, Adult, Anti-HIV Agents, Biomarkers, C-Reactive Protein, CD4 Lymphocyte Count, CD4-Positive T-Lymphocytes, Cohort Studies, Drug Therapy, Combination, Female, HIV Infections, Humans, Internationality, Male, immune activation, global HIV, cART clinical outcomes, T-cell activation, ACTG PEARLS and NWCS 319 Study team, Clinical Sciences, Public Health and Health Services, Virology |
| جغرافية الموضوع: |
163 - 171 |
| الوصف: |
BackgroundDespite the success of combination antiretroviral therapy (cART), a subset of HIV-infected patients who initiate cART develop early clinical progression to AIDS; therefore, some cART initiators are not fully benefitted by cART. Immune activation pre-cART may predict clinical progression in cART initiators.MethodsA case-cohort study (n = 470) within the multinational Prospective Evaluation of Antiretrovirals in Resource-Limited Settings clinical trial (1571 HIV treatment-naive adults who initiated cART; CD4 T-cell count <300 cells/mm; 9 countries) was conducted. A subcohort of 30 participants per country was randomly selected; additional cases were added from the main cohort. Cases [n = 236 (random subcohort 36; main cohort 200)] had clinical progression (incident WHO stage 3/4 event or death) within 96 weeks after cART initiation. Immune activation biomarkers were quantified pre-cART. Associations between biomarkers and clinical progression were examined using weighted multivariable Cox-proportional hazards models.ResultsMedian age was 35 years, 45% were women, 49% black, 31% Asian, and 9% white. Median CD4 T-cell count was 167 cells per cubic millimeter. In multivariate analysis, highest quartile C-reactive protein concentration [adjusted hazard ratio (aHR), 2.53; 95% confidence interval (CI): 1.02 to 6.28] and CD4 T-cell activation (aHR, 5.18; 95% CI: 1.09 to 24.47) were associated with primary outcomes, compared with lowest quartiles. sCD14 had a trend toward association with clinical failure (aHR, 2.24; 95% CI: 0.96 to 5.21).ConclusionsMeasuring C-reactive protein and CD4 T-cell activation may identify patients with CD4 T-cell counts <300 cells per cubic millimeter at risk for early clinical progression when initiating cART. Additional vigilance and symptom-based screening may be required in this subset of patients even after beginning cART. |
| نوع الوثيقة: |
article in journal/newspaper |
| وصف الملف: |
application/pdf |
| اللغة: |
unknown |
| العلاقة: |
qt7sj211md; https://escholarship.org/uc/item/7sj211mdTest |
| الإتاحة: |
https://escholarship.org/uc/item/7sj211mdTest |
| حقوق: |
public |
| رقم الانضمام: |
edsbas.F5429123 |
| قاعدة البيانات: |
BASE |
