| Author | Epeldegui, Marta | |
| Author | Di, Chang | |
| Author | Lee, Jeannette | |
| Author | Magpantay, Larry I. | |
| Author | Borok, Margaret | |
| Author | Bukuru, Aggrey | |
| Author | Busakhala, Naftali | |
| Author | Godfrey, Catherine | |
| Author | Hosseinipour, Mina C. | |
| Author | Kang, Minhee | |
| Author | Kanyama, Cecilia | |
| Author | Langat, Deborah | |
| Author | Mngqibisa, Rosie | |
| Author | Mwelase, Noluthando | |
| Author | Nyirenda, Mulinda | |
| Author | Samaneka, Wadzanai | |
| Author | Hoagland, Brenda | |
| Author | Campbell, Thomas B. | |
| Author | Martínez-Maza, Otoniel | |
| Author | Krown, Susan E. | |
| Access date | 2023-11-07T23:15:59Z | |
| Available date | 2023-11-07T23:15:59Z | |
| Document date | 2023 | |
| Citation | EPELDEGUI, Marta et al. Predictive Value of Serum Biomarkers for Response of Limited-Stage AIDS-Associated Kaposi Sarcoma to Antiretroviral Therapy With or Without Concomitant Chemotherapy in Resource-Limited Settings. Journal of Acquired Immune Deficiency Syndromes, v. 94, n. 2, p. 165-173, Oct. 2023. | en_US |
| ISSN | 1525-4135 | en_US |
| URI | https://www.arca.fiocruz.br/handle/icict/61088 | |
| Description | The authors would like to thank the site staff and participants who participated in A5264/AMC-067. | en_US |
| Language | eng | en_US |
| Publisher | Lippincott Williams & Wilkins | en_US |
| Rights | restricted access | |
| Title | Predictive Value of Serum Biomarkers for Response of Limited-Stage AIDS-Associated Kaposi Sarcoma to Antiretroviral Therapy With or Without Concomitant Chemotherapy in Resource-Limited Settings | en_US |
| Type | Article | |
| DOI | 10.1097/QAI.0000000000003236 | |
| Abstract | Background: Guidelines for limited-stage human immunodeficiency virus-associated Kaposi sarcoma (AIDS/KS) recommend antiretroviral therapy (ART) as initial treatment. However, many such individuals show worsening KS and require additional chemotherapy. Methods to identify such patients are lacking. Setting: We studied whether serum levels of biomarkers associated with angiogenesis, systemic inflammation, and immune activation, which are elevated in HIV-infected individuals and implicated in the development of KS, could prospectively identify individuals with limited-stage AIDS-KS who would benefit from chemotherapy administered with ART. Methods: Serum specimens were obtained from participants in a randomized trial evaluating the value of adding oral etoposide chemotherapy to ART in treatment-naïve people with limited-stage AIDS-KS in resource-limited settings. Serum biomarkers of inflammation (C-reactive protein [CRP], interleukin [IL]-6, IL-8, IL-10, granulocyte colony stimulating factor, soluble tumor necrosis factor receptor-2), immune system activation (soluble IL-2 receptor alfa, C-X-C motif chemokine ligand 10/interferon gamma-induced protein 10, C-C motif ligand 2/monocyte chemoattractant protein 1), and angiogenesis (vascular endothelial growth factor, matrix metalloproteinase-2, -9, endoglin, hepatocyte growth factor) were measured at entry to determine whether baseline levels are associated with KS response. On-treatment changes in biomarker levels were determined to assess how etoposide modifies the effects of ART. Results: Pretreatment CRP and IL-10 were higher in those whose KS progressed, and lowest in those who had good clinical responses. Pretreatment CRP, IL-6, and soluble tumor necrosis factor receptor-2 showed significant associations with KS progression at the week-48 primary endpoint. Immediate etoposide led to lower inflammation biomarker levels compared with ART alone. Early KS progression was associated with elevated pretreatment levels of inflammation-associated biomarkers and increasing levels post-treatment. Conclusions: Quantifying serum biomarkers, especially CRP, may help identify persons with AIDS-KS who would benefit from early introduction of chemotherapy in addition to ART. Trial registration: ClinicalTrials.gov NCT01352117. | en_US |
| Affilliation | Department of Obstetrics and Gynecology. University of California. Los Angeles, CA, USA. | en_US |
| Affilliation | Department of Biostatistics. University of Arkansas for Medical Sciences. Little Rock, AR. | en_US |
| Affilliation | Department of Biostatistics. University of Arkansas for Medical Sciences. Little Rock, AR. | en_US |
| Affilliation | Department of Obstetrics and Gynecology. University of California. Los Angeles, CA, USA. | en_US |
| Affilliation | Unit of Internal Medicine. Faculty of Medicine and Health Sciences. University of Zimbabwe. Harare, Zimbabwe. | en_US |
| Affilliation | Joint Clinical Research Center. Kampala, Uganda. | en_US |
| Affilliation | Department of Pharmacology. Moi University School of Medicine. Eldoret, Kenya. | en_US |
| Affilliation | Office of the Global AIDS Coordinator. Department of State. Washington, DC, USA. | en_US |
| Affilliation | Department of Medicine. Division of Infectious Diseases. University of North Carolina Project. Lilongwe, Malawi. | en_US |
| Affilliation | Center for Biostatistics in AIDS Research in the Department of Biostatistics. Harvard School of Public Health. Boston, MA, USA. | en_US |
| Affilliation | Department of Medicine. Division of Infectious Diseases. University of North Carolina Project. Lilongwe, Malawi. | en_US |
| Affilliation | Department of Research. KEMRI Walter Reed Project. Kericho, Kenya. | en_US |
| Affilliation | Research Unit. Enhancing Care Foundation. Durban International Clinical Research Site. King Edward Hospital. Enhancing Care Foundation. Durban, South Africa. | en_US |
| Affilliation | Department of Internal Medicine. University of Witwatersrand. Johannesburg, South Africa. | en_US |
| Affilliation | College of Medicine-Johns Hopkins Research Project. Blantyre, Malawi. | en_US |
| Affilliation | Unit of Internal Medicine. Faculty of Medicine and Health Sciences. University of Zimbabwe. Harare, Zimbabwe. | en_US |
| Affilliation | Oswaldo Cruz Foundation. Evandro Chagas National Institute of Infectious Diseases. Department of Infectious Diseases. Rio de Janeiro, RJ, Brazil. | en_US |
| Affilliation | Department of Medicine. University of Colorado School of Medicine Aurora. Colorado, CO, USA. | en_US |
| Affilliation | Department of Obstetrics and Gynecology. University of California. Los Angeles, CA, USA. | en_US |
| Affilliation | Department of Medicine. Memorial Sloan-Kettering Cancer Center (Emerita). New York, NY, USA. | en_US |
| Subject | Kaposi sarcoma | en_US |
| Subject | Inflammation | en_US |
| Subject | AIDS | en_US |
| Subject | HIV | en_US |
| Subject | Chemotherapy | en_US |
| e-ISSN | 1944-7884 | |
| Embargo date | 2030-12-31 | |
