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- Title
Persistent Immune Activation and Carotid Atherosclerosis in HIV-Infected Ugandans Receiving Antiretroviral Therapy.
- Authors
Siedner, Mark J.; June-Ho Kim; Nakku, Ruth Sentongo; Bibangambah, Prossy; Hemphill, Linda; Triant, Virginia A.; Haberer, Jessica E.; Martin, Jeffrey N.; Mocello, A. Rain; Boumll, Yap; Kwon, Douglas S.; Tracy, Russell P.; Burdo, Tricia; Yong Huang; Cao, Huyen; Okello, Samson; Bangsberg, David R.; Hunt, Peter W.; Kim, June-Ho; Boum, Yap 2nd
- Abstract
<bold>Background: </bold>Human immunodeficiency virus (HIV) infection and associated immune activation predict the risk of cardiovascular disease in resource-rich areas. Less is known about these relationships in sub-Saharan Africa.<bold>Methods: </bold>Beginning in 2005, we enrolled subjects in southwestern Uganda into a cohort at the time of antiretroviral therapy (ART) initiation. Multiple immune activation measures were assessed before and 6 months after ART initiation. Beginning in 2013, participants aged >40 years underwent metabolic profiling, including measurement of hemoglobin A1c and lipid levels and carotid ultrasonography. We fit regression models to identify traditional and HIV-specific correlates of common carotid intima media thickness (CCIMT).<bold>Results: </bold>A total of 105 participants completed carotid ultrasonography, with a median completion time of 7 years following ART initiation. Age, low-density lipoprotein cholesterol level, and pre-ART HIV load were correlated with CCIMT. No association was found between CCIMT and any pre-ART biomarkers of immune activation. However, in multivariable models adjusted for cardiovascular disease risk factors, lower absolute levels of soluble CD14 and interleukin 6 and greater declines in the CD14 level and kynurenine-tryptophan ratio after 6 months of ART predicted a lower CCIMT years later (P < .01).<bold>Conclusions: </bold>Persistent immune activation despite ART-mediated viral suppression predicts the future atherosclerotic burden among HIV-infected Ugandans. Future work should focus on clinical correlates of these relationships, to elucidate the long-term health priorities for HIV-infected people in the region.
- Subjects
UGANDA; IMMUNE response; ATHEROSCLEROSIS; HIV-positive persons; ANTIRETROVIRAL agents; UGANDANS; INFLAMMATION; AGING; HIV infection epidemiology; HIV infection complications; ANTI-HIV agents; CYTOKINES; CAROTID artery diseases; GENES; RESEARCH funding; ANTIGENS; LONGITUDINAL method
- Publication
Journal of Infectious Diseases, 2016, Vol 213, Issue 3, p370
- ISSN
0022-1899
- Publication type
journal article
- DOI
10.1093/infdis/jiv450