Pre-cART elevation of CRP and CD4+ T-cell immune activation associated with HIV clinical progression in a multinational case-cohort study

Post Date:

2015-10-01

Countries:

Brazil

Clinical Sites:

Publication:

Journal of Acquired Immune Deficiency Syndromes

Summary:

Background: Despite 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.

Methods: A 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.

Citation:

Balagopal A, Asmuth DM, Yang W-T, Campbell T, Gupte N, Smeaton L, Kanyama C, Grinsztejn B, Santos B, Supparatpinyo K, Badal-Faesen S, Lama JR, Lalloo U, Zulu F, Pawar JS, Riviere C, Kumarasamy N, Hakim J, Li X-D, Pollard RB, Semba RD, Thomas DL, Bollinger RC, Gupta A. Pre-cART elevation of CRP and CD4+ T-cell immune activation associated with HIV clinical progression in m Multinational case-cohort study. J Acquir Immune Def Syndr. 2015 Oct 1.

Staff:

Bob Bollinger, MD, MPH

Amita Gupta, MD, MHS

Collaborators:

Department of Medicine, University of California Davis, Sacramento, CA
Department of Medicine, University of Colorado Denver, Aurora, CO
Harvard University Center for AIDS Research, Harvard School of Public Health, Boston, MA
University of North Carolina Project, Lilongwe, Malawi
Instituto de Pesquisa Clinica Evandro Chagas, Manguinhos, Brazil
Hospital Nossa Senhora da Conceição, Porto Alegre, Brazil
Department of Medicine, Chiang Mai University, Chiang Mai, Thailand
Department of Medicine, University of Witwatersrand, Johannesburg, South Africa
IMPACTA PERU Clinical Trials Unit, Asociacion Civil Impacta Salud y Educacion, Lima, Peru
Department of Pulmonology, Nelson R Mandela School of Medicine, University of KwaZulu Natal, Durban, South Africa
Malawi College of Medicine-Johns Hopkins Research Project, Kachere Rehabilitation Centre, Blantyre, Malawi
National AIDS Research Institute, Pune, India
Les Centres GHESKIO, Port-au-Prince, Haïti
YR Gaitonde Center for AIDS Research and Education, Chennai, India
Department of Medicine, University of Zimbabwe, Harare, Zimbabwe