Brief Report: Changes in Levels of Inflammation After Antiretroviral Treatment During Early HIV Infection in AIDS Clinical Trials Group Study A5217.

TitleBrief Report: Changes in Levels of Inflammation After Antiretroviral Treatment During Early HIV Infection in AIDS Clinical Trials Group Study A5217.
Publication TypeJournal Article
Year of Publication2017
AuthorsMacatangay BJ, Yang M, Sun X, Morton J, De Gruttola V, Little S, Hogan C, Rinaldo CR
Corporate AuthorsA5217 Team
JournalJ Acquir Immune Defic Syndr
Volume75
Issue1
Pagination137-141
Date Published2017 05 01
ISSN1944-7884
KeywordsADP-ribosyl Cyclase 1, Adult, Anti-Retroviral Agents, Biomarkers, Blood Coagulation, C-Reactive Protein, CD4-Positive T-Lymphocytes, CD8-Positive T-Lymphocytes, Female, Fibrin Fibrinogen Degradation Products, HIV Infections, HLA-DR Antigens, Humans, Inflammation, Lipopolysaccharide Receptors, Lymphocyte Activation, Male, Membrane Glycoproteins, Plasma, Treatment Outcome
Abstract

BACKGROUND: We evaluated the changes in the levels of soluble biomarkers of inflammation and coagulation and T-cell activation among participants of AIDS Clinical Trials Group Study A5217 who were started on antiretroviral therapy (ART) within the first 6 months of HIV infection.

METHODS: Cryopreserved specimens were obtained pre-ART (week 0), at the time of virologic suppression (week 36), and at 36 weeks after treatment interruption (week 72). Levels of D-dimer, C-reactive protein (CRP), and soluble CD14 (sCD14) were measured in plasma, whereas T-cell activation levels, defined as the frequencies of CD4 and CD8 T cells coexpressing HLA-DR and CD38, were measured in peripheral blood mononuclear cells.

RESULTS: D-dimer levels were significantly lower at viral suppression (P = 0.031), whereas CRP and sCD14 levels remained similar to pre-ART levels. At viral suppression, levels of the soluble markers did not correlate with each other. CD4 T-cell counts pre-ART tended to modestly correlate with levels of D-dimer (r = 0.35; P = 0.058) and CRP (r = 0.33; P = 0.078). At 36 weeks after treatment interruption (week 72), D-dimer levels returned back to pre-ART levels. However, CD8 T-cell activation was significantly lower than pre-ART levels (35.8% at week 0 vs 28.9% at week 72; P = 0.004).

CONCLUSIONS: Among the A5217 participants who started ART within the first 6 months of HIV infection, high levels of sCD14 and CRP remain similar to pre-ART levels, suggesting that immune damage occurring in the initial stages of infection persists despite short-term virologic suppression.

DOI10.1097/QAI.0000000000001320
Alternate JournalJ. Acquir. Immune Defic. Syndr.
PubMed ID28198712
PubMed Central IDPMC5393630
Grant ListUM1 AI069432 / AI / NIAID NIH HHS / United States
UM1 AI068634 / AI / NIAID NIH HHS / United States
U01 AI069432 / AI / NIAID NIH HHS / United States
U01 AI043638 / AI / NIAID NIH HHS / United States
UM1 AI106701 / AI / NIAID NIH HHS / United States
U01 AI068634 / AI / NIAID NIH HHS / United States
UM1 AI068636 / AI / NIAID NIH HHS / United States