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Serum albumin level predicts serious HIV events
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A lower level of serum albumin is a predictor for serious non-AIDS events in patients with HIV, according to researchers.
Levels of the globular protein may be used to assess the risk for noncommunicable diseases in patients with HIV, they wrote in The Journal of Infectious Diseases.
“We found that lower serum albumin was a strong predictor of serious non-AIDS events and hospitalization in seemingly healthy HIV-infected persons ... with high CD4 counts,” researcher Andreas Ronit, MD, of the University of Copenhagen department of infectious diseases, and colleagues wrote. “These associations were independent of traditional risk factors and various laboratory measures.”
Serum albumin is sampled in many clinical settings, the researchers noted, and previous literature has suggested that low amounts of it are associated with HIV-related comorbidities like inflammation, liver disease and nephropathy.
To test serum albumin as a disease marker, they assessed data from the Strategic Timing of Antiretroviral Treatment (START) study, which was conducted between 2009 and 2013. The researchers included baseline serum albumin measures from 4,576 patients, who represented 98% of START participants, and assessed treatment outcomes.
Serious non-AIDS events were defined as cardiovascular disease, end-stage renal disease, liver disease, non-AIDS-defining cancer, death from any of those conditions, and death not related to AIDS, accident or violence.
In all, 71 patients had serious non-AIDS events, 63 had AIDS events and 788 were hospitalized. A higher baseline serum albumin level per 1 g/dL was associated with a decreased risk for serious non-AIDS events (adjusted HR = 0.37) and for hospitalization (aHR = 0.78). It was not associated with a risk for AIDS, the researchers said.
They concluded that further research can reveal more about serum albumin’s role in HIV care, including ways in which its levels can be manipulated.
“Further studies are needed to ascertain whether serum albumin can be combined with other biomarkers in prognostic or frailty indexes, if serum albumin is associated with development of specific non-AIDS pathologies and if it is possible to identify interventions, other than ART, that lower or raise serum albumin,” the researchers wrote. – by Joe Green
Disclosures: Ronit reports receiving travel grants from Gilead Sciences. Please see the study for all other authors’ relevant financial disclosures.
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