Markers of inflammation, coagulation, and renal function are elevated in adults with HIV infection.

Abstract

BACKGROUND:

Human immunodeficiency virus (HIV) replication and immune activation may increase inflammation and coagulation biomarkers. Limited data exist comparing such biomarkers in persons with and without HIV infection.

METHODS:

For persons 45-76 years of age, levels of high-sensitivity C-reactive protein (hsCRP), interleukin (IL)-6, D-dimer, and cystatin C were compared in 494 HIV-infected individuals in the Strategies for Management of Anti-Retroviral Therapy (SMART) study and 5386 participants in the Multi-Ethnic Study of Atherosclerosis (MESA) study. For persons 33-44 years of age, hsCRP and IL-6 levels were compared in 287 participants in the SMART study and 3231 participants in the Coronary Artery Development in Young Adults (CARDIA) study.

RESULTS:

hsCRP and IL-6 levels were 55% (P < . 001) and 62 (P < . 001) higher among HIV-infected participants than among CARDIA study participants. Compared with levels noted in MESA study participants, hsCRP, IL-6, D-dimer, and cystatin C levels were 50%, 152%, 94%, and 27% higher, respectively (P < . 001, for each), among HIV-infected participants. HIV-infected participants receiving antiretroviral therapy who had HIV RNA levels 400 copies/mL had levels higher (by 21% to 60%) (P < . 001) than those in the general population, for all biomarkers.

CONCLUSIONS:

hsCRP, IL-6, D-dimer, and cystatin C levels are elevated in persons with HIV infection and remain so even after HIV RNA levels are suppressed with antiretroviral therapy. Additional research is needed on the pathophysiology of HIV-induced activation of inflammatory and coagulation pathways, to guide potential interventions.

• Authors: Jacqueline Neuhaus, David R Jacobs Jr, Jason V Baker, Alexandra Calmy, Daniel Duprez, Alberto La Rosa, Lewis H Kuller, Sarah L Pett, Matti Ristola, Michael J Ross, Michael G Shlipak, Russell Tracy, James D Neaton
• Journal: The Journal of infectious diseases (J Infect Dis) Vol. 201 Issue 12 Pg. 1788-95 (Jun 15 2010) ISSN: 1537-6613 [Electronic] United States
• PMID: 20446848 (Publication Type: Journal Article, Research Support, N.I.H., Extramural)

Chemical References

• Anti-HIV Agents
• Biomarkers
• Cystatin C
• Fibrin Fibrinogen Degradation Products
• Interleukin-6
• fibrin fragment D
• C-Reactive Protein

Topics

• Adult
• Aged
• Anti-HIV Agents (therapeutic use)
• Biomarkers
• Blood Coagulation Disorders (pathology)
• C-Reactive Protein (analysis)
• Cystatin C (blood)
• Female
• Fibrin Fibrinogen Degradation Products (analysis)
• HIV Infections (complications, drug therapy)
• Humans
• Inflammation (pathology)
• Interleukin-6 (blood)
• Kidney Diseases (pathology)
• Male
• Middle Aged
• Viral Load