Biomarkers of inflammation and coagulation predict non-AIDS-defining events in a prospective cohort of virologically suppressed people living with HIV.

IF 2.8 3区医学 Q2 INFECTIOUS DISEASES

HIV Medicine Pub Date : 2025-03-25 DOI:10.1111/hiv.70017

Maria Saumoy, Analuz Fernandez, Juan Tiraboschi, Judith Peñafiel, José Luis Sánchez-Quesada, Jaime Vega, Benito García, Irene Soriano, Daniel Podzamczer, Arkaitz Imaz

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引用次数: 0

Abstract

Objective: To assess the association between biomarkers of inflammation, coagulation and immune activation and the incidence of non-AIDS-defining events in a contemporary, antiretroviral therapy (ART)-experienced and virologically suppressed cohort of people living with HIV (PLWH).

Methods: Prospective, observational cohort study. PLWH aged 30-70 years, with undetectable HIV viral load and no history of cardiovascular disease, randomly selected from outpatients were included. At baseline, plasma biomarkers (high-sensitivity C-reactive protein [hs-CRP], sCD163, sCD14, D-dimer, interleukin-6, soluble vascular cell adhesion molecule [s-VCAM] and lipoprotein-associated phospholipase A2 [Lp-PLA2] activity) were measured. Non-AIDS-defining events (non-AIDS cancer and cardiovascular events) and non-AIDS death were recorded until November 2022. Cumulative incidence was analysed for each endpoint and adjusted Cox regression used to assess associations.

Results: A total of 438 participants were included: 81.1% men, mean age 50.4 (SD 10.1) years. The median time on treatment was 15.5 (interquartile range [IQR] 8.69; 19.7) years and with undetectable viral load 7.05 (IQR 4.03; 11.6) years. A total of 77 non-AIDS-defining events were recorded in 70 patients (38 non-AIDS cancers, 21 cardiovascular events, 37 non-AIDS deaths) in a median follow-up of 6.72 (IQR 6.02; 7.36) years. The cumulative incidence for non-AIDS cancer, cardiovascular event and non-AIDS death was 8.7% (95% CI 6.2-11.7), 4.79% (95% CI 2.99-7.24) and 8.47% (95% CI 6-11.5), respectively. In adjusted models, sCD163 was associated with incident non-AIDS cancer (hazard ratio [HR] 1.23, 95% CI 1.08-1.39), hs-CRP with incident cardiovascular events (HR 1.61, 95% CI 1.05-2.47), sCD163 (HR 1.28, 95% CI 1.11-1.46) and D-dimer (HR 1.75, 95% CI 1.08-2.86) with non-AIDS death.

Conclusions: Biomarkers of inflammation, monocyte activation and coagulation were associated with non-AIDS-defining events in a contemporary and long-term suppressed cohort of PLWH.

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在病毒学抑制的HIV感染者的前瞻性队列中，炎症和凝血生物标志物预测非艾滋病决定性事件。

目的：评估当代抗逆转录病毒治疗（ART）经历和病毒学抑制的HIV感染者（PLWH）队列中炎症、凝血和免疫激活的生物标志物与非艾滋病定义事件发生率之间的关系。方法：前瞻性、观察性队列研究。从门诊患者中随机选择年龄在30-70岁、HIV病毒载量检测不到且无心血管疾病史的PLWH。基线时，测定血浆生物标志物（高敏c反应蛋白[hs-CRP]、sCD163、sCD14、d -二聚体、白介素-6、可溶性血管细胞粘附分子[s-VCAM]和脂蛋白相关磷脂酶A2 [Lp-PLA2]活性）。非艾滋病定义事件（非艾滋病癌症和心血管事件）和非艾滋病死亡被记录到2022年11月。对每个终点的累积发病率进行分析，并使用校正Cox回归来评估相关性。结果：共纳入438名参与者：81.1%为男性，平均年龄50.4岁（SD 10.1）。治疗的中位时间为15.5(四分位数间距[IQR] 8.69；19.7)岁，病毒载量检测不到7.05 (IQR 4.03；11.6)年。在中位随访时间为6.72 (IQR为6.02；7.36)年。非艾滋病癌症、心血管事件和非艾滋病死亡的累积发生率分别为8.7% （95% CI 6.2-11.7）、4.79% （95% CI 2.99-7.24）和8.47% （95% CI 6-11.5）。在调整后的模型中，sCD163与非艾滋病癌症的发生相关（风险比[HR] 1.23, 95% CI 1.08-1.39）， hs-CRP与心血管事件的发生相关（风险比[HR] 1.61, 95% CI 1.05-2.47）， sCD163（风险比1.28,95% CI 1.11-1.46）和d -二聚体（风险比1.75,95% CI 1.08-2.86）与非艾滋病死亡相关。结论：在当代和长期抑制的PLWH队列中，炎症、单核细胞活化和凝血的生物标志物与非艾滋病决定性事件相关。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

HIV Medicine 医学-传染病学

CiteScore

5.10

自引率

10.00%

发文量

167

审稿时长

6-12 weeks

期刊介绍： HIV Medicine aims to provide an alternative outlet for publication of international research papers in the field of HIV Medicine, embracing clinical, pharmocological, epidemiological, ethical, preclinical and in vitro studies. In addition, the journal will commission reviews and other feature articles. It will focus on evidence-based medicine as the mainstay of successful management of HIV and AIDS. The journal is specifically aimed at researchers and clinicians with responsibility for treating HIV seropositive patients.