| Author | Pereira, Mariana Araújo | |
| Author | Krishnan, Sonya | |
| Author | Salgame, Padmini | |
| Author | Manabe, Yukari C. | |
| Author | Hosseinipour, Mina C. | |
| Author | Bisson, Gregory | |
| Author | Severe, Damocles Patrice | |
| Author | Rouzier, Vanessa | |
| Author | Leong, Samantha | |
| Author | Mave, Vidya | |
| Author | Sawe, Fredrick Kipyego | |
| Author | Siika, Abraham M. | |
| Author | Kanyama, Cecilia | |
| Author | Dadabhai, Sufia S. | |
| Author | Lama, Javier R. | |
| Author | Huamani, Javier Valencia | |
| Author | Badal-Faesen, Sharlaa | |
| Author | Lalloo, Umesh Gangaram | |
| Author | Naidoo, Kogieleum | |
| Author | Mohapi, Lerato | |
| Author | Kityo, Cissy | |
| Author | Andrade, Bruno B. | |
| Author | Guptae, Amita | |
| Access date | 2023-11-30T13:53:09Z | |
| Available date | 2023-11-30T13:53:09Z | |
| Document date | 2023 | |
| Citation | PEREIRA, Mariana Araújo et al. Effect of the relationship between anaemia and systemic inflammation on the risk of incident tuberculosis and death in people with advanced HIV: a sub-analysis of the REMEMBER Trial. EClinical Medicine, v. 60, p 1-12, 2023. | en_US |
| ISSN | 2589-5370 | en_US |
| URI | https://www.arca.fiocruz.br/handle/icict/61571 | |
| Sponsorship | National Institutes of Health.
National Institute of Allergy and Infectious Diseases (NIAID)
National Institutes of Health (NIH)
Johns Hopkins Baltimore Índia.
Coordenação de Aperfeiçoamento de Pessoal de Nível Superior (CAPES).
Program FIOCRUZ .
National Institutes of Health.
Johns Hopkins University Clinician Scientist Award. | en_US |
| Language | eng | en_US |
| Publisher | Elsevier | en_US |
| Rights | open access | en_US |
| Subject in Portuguese | Tuberculose | en_US |
| Subject in Portuguese | Hemoglobina | en_US |
| Subject in Portuguese | Inflamação sistêmica | en_US |
| Subject in Portuguese | HIV | en_US |
| Subject in Portuguese | Incidente TB | en_US |
| Subject in Portuguese | Anemia | en_US |
| Subject in Portuguese | Inflamação | en_US |
| Subject in Portuguese | Morte | en_US |
| Title | Effect of the relationship between anaemia and systemic inflammation on the risk of incident tuberculosis and death in people with advanced HIV: a sub-analysis of the REMEMBER trial | en_US |
| Type | Article | en_US |
| DOI | 10.1016/j.eclinm.2023.102030 | |
| Abstract | Background: Tuberculosis (TB) is an infectious morbidity that commonly occurs in people living with HIV (PWH) and increases the progression of HIV disease, as well as the risk of death. Simple markers of progression are much needed to identify those at highest risk for poor outcome. This study aimed to assess how baseline severity of anaemia and associated inflammatory profiles impact death and the incidence of TB in a cohort of PWH who received TB preventive therapy (TPT). Methods: This study is a secondary posthoc analysis of the AIDS Clinical Trials Group A5274 REMEMBER clinical trial (NCT0138008), an open-label randomised clinical trial of antiretroviral-naïve PWH with CD4 <50 cells/μL, performed from October 31, 2011 to June 9, 2014, from 18 outpatient research clinics in 10 low- and middle-income countries (Malawi, South Africa, Haiti, Kenya, Zambia, India, Brazil, Zimbabwe, Peru, and Uganda) who initiated antiretroviral therapy and either isoniazid TPT or 4-drug empiric TB therapy. Plasma concentrations of several soluble inflammatory biomarkers were measured prior to the commencement of antiretroviral and anti-TB therapies, and participants were followed up for at least 48 weeks. Incident TB or death during this period were primary outcomes. We performed multidimensional analyses, logistic regression analyses, survival curves, and Bayesian network analyses to delineate associations between anaemia, laboratory parameters, and clinical outcomes. Findings: Of all 269 participants, 76.2% (n = 205) were anaemic, and 31.2% (n = 84) had severe anaemia. PWH with moderate/severe anaemia exhibited a pronounced systemic pro-inflammatory profile compared to those with mild or without anaemia, hallmarked by a substantial increase in IL-6 plasma concentrations. Moderate/severe anaemia was also associated with incident TB incidence (aOR: 3.59, 95% CI: 1.32–9.76, p = 0.012) and death (aOR: 3.63, 95% CI: 1.07–12.33, p = 0.039). Interpretation: Our findings suggest that PWH with moderate/severe anaemia display a distinct pro-inflammatory profile. The presence of moderate/severe anaemia pre-ART was independently associated with the development of TB and death. PWH with anaemia should be monitored closely to minimise the occurrence of unfavourable outcomes. | en_US |
| Affilliation | Fundação Oswaldo Cruz. Instituto Gonçalo Moniz. 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 / Faculdade de Tecnologia e Ciências. Curso de Medicina. Salvador, BA, Brasil. | en_US |
| Affilliation | Department of Medicine. Johns Hopkins University School of Medicine. Baltimore, MD, USA. | en_US |
| Affilliation | Department of Medicine. Rutgers New Jersey Medical School. Newark, USA. | en_US |
| Affilliation | Department of Medicine. Johns Hopkins University School of Medicine. Baltimore, MD, USA. | en_US |
| Affilliation | Department of Medicine. University of North Carolina at Chapel Hill. Chapel Hill, NC, USA. | en_US |
| Affilliation | University of Pennsylvania Perelman School of Medicine. Philadelphia, PA, USA. | en_US |
| Affilliation | Les Centres Haitian Group for the Study of Kaposi’s Sarcoma and Opportunistic Infections (GHESKIO). Port-au-Prince, Haiti. | en_US |
| Affilliation | Les Centres Haitian Group for the Study of Kaposi’s Sarcoma and Opportunistic Infections (GHESKIO). Port-au-Prince, Haiti. | en_US |
| Affilliation | Department of Medicine. Rutgers New Jersey Medical School. Newark, USA. | en_US |
| Affilliation | BJ Medical College Clinical Research Site. Pune, India. | en_US |
| Affilliation | Henry M. Jackson Foundation for the Advancement of Military Medicine. Bethesda, MD, USA. | en_US |
| Affilliation | Department of Medicine. School of Medicine. Moi University. Eldoret, Kenya. | en_US |
| Affilliation | University of North Carolina Project. Kamazu Central Hospital. Lilongwe, Malawi | en_US |
| Affilliation | Johns Hopkins Bloomberg School of Public Health. Blantyre, Malawi. | en_US |
| Affilliation | Asociacion Civil Impacta Salud y Educacion. Lima, Peru. | en_US |
| Affilliation | Asociacion Civil Impacta Salud y Educacion. Lima, Peru. | en_US |
| Affilliation | Clinical HIV Research Unit. School of Clinical Medicine. University of Witwatersrand, Johannesburg, South Africa. | en_US |
| Affilliation | Morningside Mediclinic. Sandton, Johannesburg, South Africa. | en_US |
| Affilliation | Centre for the AIDS Programme of Research in South Africa (CAPRISA). University of KwaZulu-Natal Nelson R Mandela School of Medicine. Durban, South Africa / SA-Medical Research Council (MRC)-CAPRISA-HIV-TB Pathogenesis and Treatment Research Unit. University of KwaZulu-Natal Nelson R Mandela School of Medicine. Durban, South Africa. | en_US |
| Affilliation | School of Clinical Medicine. University of Witwatersrand. Johannesburg. South Africa | en_US |
| Affilliation | HIV Medicine. Joint Clinical Research Centre. Kampala, Uganda. | en_US |
| Affilliation | Fundação Oswaldo Cruz. Instituto Gonçalo Moniz. 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 / Faculdade de Tecnologia e Ciências. Curso de Medicina. Salvador, BA, Brasil. | en_US |
| Affilliation | Department of Medicine. Johns Hopkins University School of Medicine. Baltimore, MD, USA. | en_US |
| Subject | Tuberculosis | en_US |
| Subject | Haemoglobin | en_US |
| Subject | Systemic inflammation | en_US |
| Subject | HIV | en_US |
| Subject | Incident TB | en_US |
| Subject | Anaemia | en_US |
| Subject | Inflammation | en_US |
| Subject | Death | en_US |
| DeCS | Tuberculose | en_US |
| DeCS | Hemoglobinas | en_US |
| DeCS | HIV | en_US |
| DeCS | Anemia | en_US |
| DeCS | Inflamação | en_US |
| DeCS | Morte | en_US |
