d-Dimer and CRP levels are elevated prior to antiretroviral treatment in patients who develop IRIS.

Abstract

Biomarkers could be useful in evaluating immune reconstitution inflammatory syndrome (IRIS). A cohort of 45 HIV-1-infected, antiretroviral treatment (ART)-naive patients with baseline CD4 T cell counts <or=100 cells/microL who were started on ART, suppressed HIV-RNA to <50 copies/mL, and seen every 1-3 months for 1 year were retrospectively evaluated for suspected or confirmed IRIS. d-Dimer, C-reactive protein (CRP), and selected autoantibodies were analyzed at baseline, 1 and 3 months post-ART in cryopreserved plasma. Median differences between cases and controls were compared with Mann-Whitney and Fisher's exact tests. Sixteen patients (35.6%) developed IRIS (median of 35 days post-ART initiation): unmasking=8, paradoxical=7, autoimmune=1. Pre-ART d-dimer and CRP were higher in IRIS cases versus controls (d-dimer: 0.89 mg/L versus 0.66 mg /L, p=0.037; CRP: 0.74 mg/L versus 0.39 mg/L, p=0.022), while d-dimer was higher in unmasking cases at IRIS onset (2.04 mg/L versus 0.36 mg /L, p=0.05). These biomarkers may be useful in identifying patients at risk for IRIS.

• Authors: Brian O Porter, G Laissa Ouedraogo, Jessica N Hodge, Margo A Smith, Alice Pau, Gregg Roby, Richard Kwan, Rachel J Bishop, Catherine Rehm, JoAnn Mican, Irini Sereti
• Journal: Clinical immunology (Orlando, Fla.) (Clin Immunol) Vol. 136 Issue 1 Pg. 42-50 (Jul 2010) ISSN: 1521-7035 [Electronic] United States
• PMID: 20227921 (Publication Type: Journal Article, Research Support, N.I.H., Extramural, Research Support, Non-U.S. Gov't)
• Copyright: (c) 2010 Elsevier Inc. All rights reserved

Chemical References

• Anti-Retroviral Agents
• Autoantibodies
• Biomarkers
• Fibrin Fibrinogen Degradation Products
• HLA-A Antigens
• fibrin fragment D
• C-Reactive Protein

Topics

• AIDS-Related Opportunistic Infections (complications, immunology)
• Adult
• Anti-Retroviral Agents (therapeutic use)
• Autoantibodies (blood, immunology)
• Biomarkers (blood)
• C-Reactive Protein (metabolism)
• CD4 Lymphocyte Count
• Female
• Fibrin Fibrinogen Degradation Products (metabolism)
• HIV Infections (blood, drug therapy)
• HIV-1 (isolation & purification)
• HLA-A Antigens (genetics)
• Humans
• Immune Reconstitution Inflammatory Syndrome (blood, diagnosis, epidemiology, etiology)
• Leukocyte Count
• Male
• Middle Aged
• Retrospective Studies
• Risk Factors