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Higher HIV RNA levels associated with elevated inflammation biomarkers
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Veterans with HIV-1 RNA of 500 copies/mL had a higher prevalence of elevated interleukin-6 and D-dimer levels vs. uninfected veterans.
This increased prevalence of interleukin-6 and D-dimer, biomarkers for inflammation and altered coagulation, occurred among veterans with HIV, although veterans without HIV had similar or higher prevalence of comorbid conditions that are also associated with higher levels of these biomarkers.
Researchers from multiple institutions in the United States investigated whether HIV status had an effect on these biomarkers and also on soluble CD14, a biomarker for monocyte activation. According to background information in the study, previous studies have suggested that HIV is associated with inflammation, altered coagulation and monocyte activation, but data were limited.
The researchers analyzed veterans from the Veterans Aging Cohort Study (VACS), an observational, prospective longitudinal study of veterans with HIV and matched uninfected veterans. Blood samples were collected from 2005 to 2006 from 1,525 veterans with HIV and 843 uninfected veterans. Interleukin-6 measurements, D-dimer measurements and soluble CD14 measurements were collected.
Compared with uninfected veterans, those with HIV had less prevalent cardiovascular disease, hypertension, diabetes, obesity and renal disease, but more prevalent dyslipidemia, hepatitis C and current smoking status. Infected veterans who had an HIV RNA level of at least 500 copies/mL or a CD4 count of less than 200 cells/mcL had significantly higher levels of interleukin-6 and D-dimer. Those with a CD4 count of less than 200 cells/mcL also had significantly higher levels of soluble CD14.
“These data suggest that both ongoing HIV replication and immune depletion and comorbid conditions, like [cardiovascular disease] and renal disease, contribute to elevated biomarkers associated with inflammation, altered coagulation and monocyte activation,” the researchers wrote. “Focusing on viremia reduction, CD4 cell restoration and treatment of non–HIV-related comorbidity may be an important strategy to reduce mortality and [cardiovascular disease] risk.”
References:
Armah KA. Clin Infect Dis. 2012;55:126-136.
Disclosures:
The researchers report no relevant financial disclosures.