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RISS 인기검색어
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- 저자 : Slike, Bonnie (검색결과 1 건)
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Sereti, Irini,Krebs, Shelly J.,Phanuphak, Nittaya,Fletcher, James L.,Slike, Bonnie,Pinyakorn, Suteeraporn,O'Connell, Robert J.,Rupert, Adam,Chomont, Nicolas,Valcour, Victor,Kim, Jerome H.,Robb, Merlin Oxford University Press 2017 Clinical Infectious Diseases Vol. No.
<P>Biomarkers of inflammation, coagulation cascade activation, and fibrosis predict serious non-AIDS during antiretroviral therapy (ART). We found increased biomarker levels in acute human immunodeficiency virus infection. Several did not normalize despite early ART initiation.</P><P> <B> <I>Background.</I> </B> Serious non-AIDS events cause substantial disease and death despite human immunodeficiency virus (HIV) suppression with antiretroviral therapy (ART). Biomarkers of inflammation, coagulation cascade activation, and fibrosis predict these end-organ events. We aimed to determine whether ART initiation during acute HIV infection would attenuate changes in these biomarker levels.</P><P> <B> <I>Methods.</I> </B> Plasma samples were obtained from participants starting ART during acute or chronic HIV infection and from HIV-uninfected participants from Bangkok, Thailand. Biomarkers of inflammation (C-reactive protein [CRP], interleukin 6, soluble interleukin 6 receptor [sIL-6R], soluble gp130, tumor necrosis factor [TNF]), enterocyte turnover (intestinal fatty acid binding protein [I-FABP]), lipopolysaccharide-induced monocyte activation (soluble CD14 [sCD14]), coagulation cascade activation [D-dimer], and fibrosis (hyaluronic acid [HA]) were measured at baseline and through 96 weeks of ART.</P><P> <B> <I>Results.</I> </B> CRP, TNF, sIL-6R, I-FABP, sCD14, D-dimer, and HA levels were elevated in acute HIV infection. Early ART was associated with increased I-FABP levels but normalization of TNF, sIL-6R, and D-dimer levels. CRP, sCD14, and HA levels decreased during ART but remained elevated compared with HIV-uninfected participants. Higher sCD14, CRP, and D-dimer levels were associated with higher peripheral blood mononuclear cell and gut integrated HIV DNA levels. Decreases in sCD14 and CRP levels were correlated with increases in CD4 T-cell counts.</P><P> <B> <I>Conclusions.</I> </B> ART initiated in early acute HIV infection was associated with normalization of the coagulation cascade and several systemic inflammatory biomarkers, but the acute-phase response, enterocyte turnover, monocyte activation, and fibrosis biomarkers remained elevated. Additional interventions to attenuate inflammation may be needed to optimize clinical outcomes in persons with HIV infection.</P>
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