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https://www.arca.fiocruz.br/handle/icict/55135
RELATIONSHIP BETWEEN ANEMIA AND SYSTEMIC INFLAMMATION IN PEOPLE LIVING WITH HIV AND TUBERCULOSIS: A SUB-ANALYSIS OF THE CADIRIS CLINICAL TRIAL
Author
Affilliation
1 Instituto Gonçalo Moniz. Fundação Oswaldo Cruz. Salvador, BA, Brasil / Multinational Organization Network Sponsoring Translational and Epidemiological Research (MONSTER) Initiative. Salvador, BA, Brasil / Universidade Federal da Bahia. Programa de Pós-graduação em Patologia Humana e Experimental. Salvador, BA, Brasil.
Instituto Gonçalo Moniz. Fundação Oswaldo Cruz. Salvador, BA, Brasil / Multinational Organization Network Sponsoring Translational and Epidemiological Research (MONSTER) Initiative. Salvador, BA, Brasil Universidade Federal do Rio de Janeiro. Programa de Pós-graduação em Clínica Médica. Rio de Janeiro, RJ, Brasil / Universidade Salvador. Curso de Medicina. Salvador, BA, Brasil.
Instituto Gonçalo Moniz. Fundação Oswaldo Cruz. Salvador, BA, Brasil / Multinational Organization Network Sponsoring Translational and Epidemiological Research (MONSTER) Initiative. Salvador, BA, Brasil / Universidad Peruana Cayetano Heredia. Instituto de Medicina Tropical Alexander Von Humboldt. Lima, Peru.
Department of Solid Tumor Oncology. Levine Cancer Institute. Charlotte, NC, United States.
Instituto Gonçalo Moniz. Fundação Oswaldo Cruz. Salvador, BA, Brasil / Multinational Organization Network Sponsoring Translational and Epidemiological Research (MONSTER) Initiative. Salvador, BA, Brasil / Fundação Baiana para o Desenvolvimento das Ciências. Escola Bahiana de Medicina e Saúde Pública. Salvador, BA, Brasil.
Infectious Diseases Department, Instituto Nacional de Ciencias Médicas y Nutrición Salvador Zubirán. Mexico City, Mexico.
National Institutes of Allergy and Infectious Diseases, National Institutes of Health, Bethesda, MD, United States.
The Wistar Institute. Philadelphia, PA, United States.
Division of Infectious Diseases and HIV Medicine. Department of Medicine. Case Western Reserve University. Cleveland, OH, United States.
National Institutes of Allergy and Infectious Diseases, National Institutes of Health, Bethesda, MD, United States.
Infectious Diseases Department, Instituto Nacional de Ciencias Médicas y Nutrición Salvador Zubirán. Mexico City, Mexico.
Instituto Gonçalo Moniz. Fundação Oswaldo Cruz. Salvador, BA, Brasil / Multinational Organization Network Sponsoring Translational and Epidemiological Research (MONSTER) Initiative. Salvador, BA, Brasil / Fundação Baiana para o Desenvolvimento das Ciências. Escola Bahiana de Medicina e Saúde Pública. Salvador, BA, Brasil / Universidade Federal da Bahia. Programa de Pós-graduação em Patologia Humana e Experimental. Salvador, BA, Brasil / Universidade Federal do Rio de Janeiro. Programa de Pós-graduação em Clínica Médica. Rio de Janeiro, RJ, Brasil / Universidade Salvador. Curso de Medicina. Salvador, BA, Brasil / Fundação Baiana para o Desenvolvimento das Ciências. Escola Bahiana de Medicina e Saúde Pública. Salvador, BA, Brasil.
Instituto Gonçalo Moniz. Fundação Oswaldo Cruz. Salvador, BA, Brasil / Multinational Organization Network Sponsoring Translational and Epidemiological Research (MONSTER) Initiative. Salvador, BA, Brasil Universidade Federal do Rio de Janeiro. Programa de Pós-graduação em Clínica Médica. Rio de Janeiro, RJ, Brasil / Universidade Salvador. Curso de Medicina. Salvador, BA, Brasil.
Instituto Gonçalo Moniz. Fundação Oswaldo Cruz. Salvador, BA, Brasil / Multinational Organization Network Sponsoring Translational and Epidemiological Research (MONSTER) Initiative. Salvador, BA, Brasil / Universidad Peruana Cayetano Heredia. Instituto de Medicina Tropical Alexander Von Humboldt. Lima, Peru.
Department of Solid Tumor Oncology. Levine Cancer Institute. Charlotte, NC, United States.
Instituto Gonçalo Moniz. Fundação Oswaldo Cruz. Salvador, BA, Brasil / Multinational Organization Network Sponsoring Translational and Epidemiological Research (MONSTER) Initiative. Salvador, BA, Brasil / Fundação Baiana para o Desenvolvimento das Ciências. Escola Bahiana de Medicina e Saúde Pública. Salvador, BA, Brasil.
Infectious Diseases Department, Instituto Nacional de Ciencias Médicas y Nutrición Salvador Zubirán. Mexico City, Mexico.
National Institutes of Allergy and Infectious Diseases, National Institutes of Health, Bethesda, MD, United States.
The Wistar Institute. Philadelphia, PA, United States.
Division of Infectious Diseases and HIV Medicine. Department of Medicine. Case Western Reserve University. Cleveland, OH, United States.
National Institutes of Allergy and Infectious Diseases, National Institutes of Health, Bethesda, MD, United States.
Infectious Diseases Department, Instituto Nacional de Ciencias Médicas y Nutrición Salvador Zubirán. Mexico City, Mexico.
Instituto Gonçalo Moniz. Fundação Oswaldo Cruz. Salvador, BA, Brasil / Multinational Organization Network Sponsoring Translational and Epidemiological Research (MONSTER) Initiative. Salvador, BA, Brasil / Fundação Baiana para o Desenvolvimento das Ciências. Escola Bahiana de Medicina e Saúde Pública. Salvador, BA, Brasil / Universidade Federal da Bahia. Programa de Pós-graduação em Patologia Humana e Experimental. Salvador, BA, Brasil / Universidade Federal do Rio de Janeiro. Programa de Pós-graduação em Clínica Médica. Rio de Janeiro, RJ, Brasil / Universidade Salvador. Curso de Medicina. Salvador, BA, Brasil / Fundação Baiana para o Desenvolvimento das Ciências. Escola Bahiana de Medicina e Saúde Pública. Salvador, BA, Brasil.
Abstract
People with HIV (PWH) are at increased risk of developing active tuberculosis (TB), and anemia is a common complication in both conditions. Anemia in TB patients has been linked to immune activation, levels of inflammatory biomarkers in blood, and risk for HIV disease progression and death. In this study we show that anemia was associated with a more pronounced inflammatory profile in HIV-TB coinfected persons in a cohort of 159 individuals with advanced HIV disease (CD4 count < 100 cells/µL) recruited as part of a randomized clinical trial (NCT00988780). A panel of plasma biomarkers was assessed on plasma obtained prior to combination antiretroviral therapy (cART) initiation. We performed a series of multidimensional analyses including clinical variables and concentrations of inflammatory biomarkers to profile systemic inflammation of PWH with and without anemia. We observed that TB participants presented with moderately lower levels of hemoglobin than non-TB participants. These participants also presented a higher Degree of Inflammatory Perturbation (DIP) score, related to increased levels of IFN-γ and TNF. The DIP was associated with TB coinfection and anemia before cART initiation. Future mechanistic studies are warranted to assess the determinants of such associations and the implications on treatment outcomes.
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