TY - JOUR
T1 - HIV status, burden of comorbid disease, and biomarkers of inflammation, altered coagulation, and monocyte activation
AU - Armah, Kaku A.
AU - McGinnis, Kathleen
AU - Baker, Jason
AU - Gibert, Cynthia
AU - Butt, Adeel A.
AU - Bryant, Kendall J.
AU - Goetz, Matthew
AU - Tracy, Russell
AU - Oursler, Krisann K.
AU - Rimland, David
AU - Crothers, Kristina
AU - Rodriguez-Barradas, Maria
AU - Crystal, Steve
AU - Gordon, Adam
AU - Kraemer, Kevin
AU - Brown, Sheldon
AU - Gerschenson, Mariana
AU - Leaf, David A.
AU - Deeks, Steven G.
AU - Rinaldo, Charles
AU - Kuller, Lewis H.
AU - Justice, Amy
AU - Freiberg, Matthew
N1 - Funding Information:
Financial support. This work was supported by the National Institute on Alcohol Abuse and Alcoholism (NIAAA) and National Heart Lung and Blood Institute (NHLBI) at the National Institutes of Health (NIH; grant numbers K23AA015914–0651, R01HC095136-04, 5R01HC095126-04 to M. F.; and U10AA013566-10 to A. J.).
Funding Information:
Potential conflict of interest. K. A., K. A. O., A. G., K. K., S. B., S. D., A. J., and M. F. received NIH/NHLBI/NIAAA grant funding for this work. M. G. has received grant funding and support from Yale University for this work. R. T. has received grant funding from the US Department of Veterans Affairs (VA) through the University of Pittsburgh for this work. R. T. owns Haematologic Technologies and has received funding from Tibotec, Merck, and Abbott, none of which pertain to this work. All other authors report no potential conflicts.
PY - 2012/7
Y1 - 2012/7
N2 - Background. Biomarkers of inflammation, altered coagulation, and monocyte activation are associated with mortality and cardiovascular disease (CVD) in the general population and among human immunodeficiency virus (HIV)-infected people. We compared biomarkers for inflammation, altered coagulation, and monocyte activation between HIV-infected and uninfected people in the Veterans Aging Cohort Study (VACS).Methods.Biomarkers of inflammation (interleukin-6 [IL-6]), altered coagulation (d-dimer), and monocyte activation (soluble CD14 [sCD14]) were measured in blood samples from 1525 HIV-infected and 843 uninfected VACS participants. Logistic regression was used to determine the association between HIV infection and prevalence of elevated (>75th percentile) biomarkers, adjusting for confounding comorbidities.Results.HIV- infected veterans had less prevalent CVD, hypertension, diabetes, obesity, hazardous drinking, and renal disease, but more dyslipidemia, hepatitis C, and current smoking than uninfected veterans. Compared to uninfected veterans, HIV-infected veterans with HIV-1 RNA ≥500 copies/mL or CD4 count <200 cells/L had a significantly higher prevalence of elevated IL-6 (odds ratio [OR], 1.54; 95 confidence interval [CI],1.14-2.09; OR, 2.25; 95 CI, 1.60-3.16, respectively) and d-dimer (OR, 1.97; 95 CI, 1.44-2.71, OR, 1.68; 95 CI, 1.22-2.32, respectively) after adjusting for comorbidities. HIV-infected veterans with a CD4 cell count <200 cells/L had significantly higher prevalence of elevated sCD14 compared to uninfected veterans (OR, 2.60; 95 CI, 1.64-4.14). These associations still persisted after restricting the analysis to veterans without known confounding comorbid conditions.Conclusions.These data suggest that ongoing HIV replication and immune depletion significantly contribute to increased prevalence of elevated biomarkers of inflammation, altered coagulation, and monocyte activation. This contribution is independent of and in addition to the substantial contribution from comorbid conditions.
AB - Background. Biomarkers of inflammation, altered coagulation, and monocyte activation are associated with mortality and cardiovascular disease (CVD) in the general population and among human immunodeficiency virus (HIV)-infected people. We compared biomarkers for inflammation, altered coagulation, and monocyte activation between HIV-infected and uninfected people in the Veterans Aging Cohort Study (VACS).Methods.Biomarkers of inflammation (interleukin-6 [IL-6]), altered coagulation (d-dimer), and monocyte activation (soluble CD14 [sCD14]) were measured in blood samples from 1525 HIV-infected and 843 uninfected VACS participants. Logistic regression was used to determine the association between HIV infection and prevalence of elevated (>75th percentile) biomarkers, adjusting for confounding comorbidities.Results.HIV- infected veterans had less prevalent CVD, hypertension, diabetes, obesity, hazardous drinking, and renal disease, but more dyslipidemia, hepatitis C, and current smoking than uninfected veterans. Compared to uninfected veterans, HIV-infected veterans with HIV-1 RNA ≥500 copies/mL or CD4 count <200 cells/L had a significantly higher prevalence of elevated IL-6 (odds ratio [OR], 1.54; 95 confidence interval [CI],1.14-2.09; OR, 2.25; 95 CI, 1.60-3.16, respectively) and d-dimer (OR, 1.97; 95 CI, 1.44-2.71, OR, 1.68; 95 CI, 1.22-2.32, respectively) after adjusting for comorbidities. HIV-infected veterans with a CD4 cell count <200 cells/L had significantly higher prevalence of elevated sCD14 compared to uninfected veterans (OR, 2.60; 95 CI, 1.64-4.14). These associations still persisted after restricting the analysis to veterans without known confounding comorbid conditions.Conclusions.These data suggest that ongoing HIV replication and immune depletion significantly contribute to increased prevalence of elevated biomarkers of inflammation, altered coagulation, and monocyte activation. This contribution is independent of and in addition to the substantial contribution from comorbid conditions.
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U2 - 10.1093/cid/cis406
DO - 10.1093/cid/cis406
M3 - Article
C2 - 22534147
AN - SCOPUS:84862236428
SN - 1058-4838
VL - 55
SP - 126
EP - 136
JO - Clinical Infectious Diseases
JF - Clinical Infectious Diseases
IS - 1
ER -