HIV infection, antiretroviral therapy initiation and longitudinal changes in biomarkers of organ function

Kaku A. So-Armah, Joyce Chang, Charles Alcorn, Vincent Lo Re, Jason V. Baker, Russell Tracy, Adeel A. Butt, Brian K. Agan, David Rimland, Cynthia L. Gibert, Matthew B. Goetz, Krisann K. Oursler, Maria C. Rodriguez-Barradas, Lewis H. Kuller, Sheldon T. Brown, James H. Stein, Melissa Skanderson, Amy C. Justice, Matthew S. Freiberg

Research output: Contribution to journalArticlepeer-review

12 Scopus citations

Abstract

Background: HIV is associated with end-organ diseases of aging via unclear mechanisms. Longitudinally assessing how HIV infection and ART initiation affect biomarkers of end organ function/disease could clarify these mechanisms. We investigated longitudinal changes in clinical biomarkers following 1) HIV infection and 2) ART initiation with evidence of viral suppression. Methods: Cohort: Veterans Aging Cohort Study Virtual Cohort (VACS VC). VACS VC is a longitudinal cohort of HIV infected (HIV+) and race-ethnicity, sex, age, and clinical site-matched uninfected Veterans enrolled in the same calendar year. Inclusion criteria: a negative and successively positive (>six months) HIV antibody test. We used Wilcoxon signedrank tests to analyze 1) the effect of HIV infection on lipids, renal, hepatic and hematologic/cardiovascular biomarkers and 2)whether ART initiation with HIV-1 RNA<500 cpm reverts any changes back to pre-HIV levels Results: 422 Veterans had at least 1 biomarker measurement available prior to HIV infection and prior to ART initiation. 297 had at least 1 biomarker measurement available prior to HIV infection and after ART initiation with evidence of viral suppression. Mean age prior to HIV infection was 43 years. HIV infection was associated with reduction in total cholesterol, HDL cholesterol, LDL cholesterol, serum albumin, ALT, platelet count, hemoglobin and elevation of FIB-4 score and triglycerides. These changes occurred without significant changes in BMI. ART initiation (with HIV-1 RNA<500cpm) did not reverse alteration in triglycerides, LDL cholesterol, hemoglobin, or FIB-4 to pre-HIV infection levels. Conclusions: HIV infection is associated with longitudinal changes in serum levels of several biomarkers of end-organ function/disease and mortality. Multiple biomarkers (triglycerides, LDL cholesterol, hemoglobin, and FIB-4) remain altered from levels prior to HIV infection levels even following inititiation of ART and evidence of viral suppression. These results give insights into underlying mechanisms of increased risk for aging-related chronic diseases in the context of HIV infection.

Original languageEnglish
Pages (from-to)50-59
Number of pages10
JournalCurrent HIV Research
Volume12
Issue number1
DOIs
StatePublished - 2014

Keywords

  • Chronic diseases of aging
  • Clinical biomarkers
  • HIV infection
  • Lipids

Fingerprint

Dive into the research topics of 'HIV infection, antiretroviral therapy initiation and longitudinal changes in biomarkers of organ function'. Together they form a unique fingerprint.

Cite this