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Different plasma markers of inflammation are influenced by immune recovery and cART composition or intensification in treated HIV infected individuals.


ABSTRACT:

Background

HIV-1 infection increases plasma levels of inflammatory markers. Combination antiretroviral therapy (cART) does not restore inflammatory markers to normal levels. Since intensification of cART with raltegravir reduced CD8 T-cell activation in the Discor-Ral and IntegRal studies, we have evaluated the effect of raltegravir intensification on several soluble inflammation markers in these studies.

Methods

Longitudinal plasma samples (0-48 weeks) from the IntegRal (n = 67, 22 control and 45 intensified individuals) and the Discor-Ral studies (44 individuals with CD4 T-cell counts<350 cells/µl, 14 control and 30 intensified) were assayed for 25 markers. Mann-Whitney, Wilcoxon, Spearman test and linear mixed models were used for analysis.

Results

At baseline, different inflammatory markers were strongly associated with HCV co-infection, lower CD4 counts and with cART regimens (being higher in PI-treated individuals), but poorly correlated with detection of markers of residual viral replication. Although raltegravir intensification reduced inflammation in individuals with lower CD4 T-cell counts, no effect of intensification was observed on plasma markers of inflammation in a global analysis. An association was found, however, between reductions in immune activation and plasma levels of the coagulation marker D-dimer, which exclusively decreased in intensified patients on protease inhibitor (PI)-based cART regimens (P = 0.040).

Conclusions

The inflammatory profile in treated HIV-infected individuals showed a complex association with HCV co-infection, the levels of CD4 T cells and the cART regimen. Raltegravir intensification specifically reduced D-dimer levels in PI-treated patients, highlighting the link between cART composition and residual viral replication; however, raltegravir had little effect on other inflammatory markers.

SUBMITTER: Massanella M 

PROVIDER: S-EPMC4252101 | biostudies-literature | 2014

REPOSITORIES: biostudies-literature

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Publications

Different plasma markers of inflammation are influenced by immune recovery and cART composition or intensification in treated HIV infected individuals.

Massanella Marta M   Ouchi Dan D   Marfil Silvia S   Llibre Josep M JM   Puertas Maria C MC   Buzón María J MJ   Richman Douglas D DD   Orna Elisa E   Stevenson Mario M   Gatell Josep M JM   Domingo Pere P   Negredo Eugènia E   Martinez-Picado Javier J   Clotet Bonaventura B   Blanco Julià J  

PloS one 20141202 12


<h4>Background</h4>HIV-1 infection increases plasma levels of inflammatory markers. Combination antiretroviral therapy (cART) does not restore inflammatory markers to normal levels. Since intensification of cART with raltegravir reduced CD8 T-cell activation in the Discor-Ral and IntegRal studies, we have evaluated the effect of raltegravir intensification on several soluble inflammation markers in these studies.<h4>Methods</h4>Longitudinal plasma samples (0-48 weeks) from the IntegRal (n = 67,  ...[more]

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