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PERSISTENTLY ELEVATED C-REACTIVE PROTEIN LEVEL IN THE FIRST YEAR OF ANTIRETROVIRAL THERAPY, DESPITE VIROLOGIC SUPPRESSION, IS ASSOCIATED WITH HIV DISEASE PROGRESSION IN RESOURCE-CONSTRAINED SETTINGS
Shivakoti, Rupak et al. | Date Issued: 2016
Author
Shivakoti, Rupak
Yang, Wei-Teng
Berendes, Sima
Mwelase, Noluthando
Kanyama, Cecilia
Pillay, Sandy
Samaneka, Wadzanai
Santos, Breno
Poongulali, Selvamuthu
Tripathy, Srikanth
Riviere, Cynthia
Lama, Javier R.
Cardoso, Sandra W.
Sugandhavesa, Patcharaphan
Balagopal, Ashwin
Gupte, Nikhil
Semba, Richard D.
Campbell, Thomas B.
Bollinger, Robert C.
Gupta, Amita
NWCS 319 and PEARLS Study Team
Affilliation
Department of Medicine, Johns Hopkins University School of Medicine, Baltimore, Maryland.
Department of Medicine, Johns Hopkins University School of Medicine, Baltimore, Maryland.
Malawi College of Medicine-Johns Hopkins University Research Project, Blantyre
Department of Medicine, University of Witwatersrand, Johannesburg.
UNC Project-Malawi, Lilongwe, Malawi.
Durban International Clinical Research Site, Durban University of Technology, South Africa.
University of Zimbabwe Clinical Research Centre, Harare.
Hospital Nossa Senhora de Conceição. Porto Alegre, Brasil.
YR Gaitonde Center for AIDS Research and Education, Chennai.
National AIDS Research Institute, Pune, India.
Les Centres GHESKIO, Port-Au-Prince, Haiti.
Asociacion Civil Impacta Salud y Educacion, Lima, Peru.
Fundação Oswaldo Cruz. Instituto Nacional de Infectologia Evandro Chagas. Laboratório de Pesquisa Clínica em DST/AIDS. Rio de Janeiro, RJ, Brasil.
Research Institute for Health Sciences, Chiang Mai, Thailand.
Department of Medicine, Johns Hopkins University School of Medicine, Baltimore, Maryland.
Department of Medicine, Johns Hopkins University School of Medicine, Baltimore, Maryland.
Department of Ophthalmology, Johns Hopkins University School of Medicine, Baltimore, Maryland.
Division of Infectious Diseases, Department of Medicine, University of Colorado School of Medicine, Aurora.
Department of Medicine, Johns Hopkins University School of Medicine, Baltimore, Maryland.
Department of Medicine, Johns Hopkins University School of Medicine, Baltimore, Maryland.
Abstract
A case-cohort analysis of human immunodeficiency virus (HIV)-infected individuals receiving antiretroviral therapy (ART) was performed within a multicountry randomized trial (PEARLS) to assess the prevalence of persistently elevated C-reactive protein (CRP) levels, based on serial measurements of CRP levels, and their association with HIV clinical failure. A persistently elevated CRP level in plasma (defined as ≥ 5 mg/L at both baseline and 24 weeks after ART initiation) was observed in 50 of 205 individuals (24%). A persistently elevated CRP level but not an elevated CRP level only at a single time point was independently associated with increased clinical failure, compared with a persistently low CRP level, despite achievement of virologic suppression. Serial monitoring of CRP levels could identify individuals who are at highest risk of HIV progression and may benefit from future adjunct antiinflammatory therapies.
Keywords
HIV
Inflammation
CRP
Persistent inflammation
Antiretroviral therapy
 
Citation
SHIVAKOTI, Rupak. et al. Persistently elevated C-reactive protein level in the first year of antiretroviral therapy, despite virologic suppression, Is associated With HIV disease progression in resource-constrained settings. The Journal of Infectious Diseases, v. 213, n. 7, p. 1074–1078, 2016.
DOI
10.1093/infdis/jiv573
ISSN
0022-1899