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Interleukin-6 and D-dimer levels at seroconversion as predictors of HIV-1 disease progression

Hamlyn, Elizabeth ; Fidler, Sarah ; Stöhr, Wolfgang ; Cooper, David A ; Tambussi, Giuseppe ; Schechter, Mauro ; Miro, Jose M ; Mcclure, Myra ; Weber, Jonathan ; Babiker, Abdel ; Porter, Kholoud

AIDS (London), 2014-03, Vol.28 (6), p.869-874 [Periódico revisado por pares]

Hagerstown, MD: Lippincott Williams & Wilkins, Inc

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Título:
Interleukin-6 and D-dimer levels at seroconversion as predictors of HIV-1 disease progression
Autor: Hamlyn, Elizabeth ; Fidler, Sarah ; Stöhr, Wolfgang ; Cooper, David A ; Tambussi, Giuseppe ; Schechter, Mauro ; Miro, Jose M ; Mcclure, Myra ; Weber, Jonathan ; Babiker, Abdel ; Porter, Kholoud
Assuntos: Adult ; Biological and medical sciences ; Disease Progression ; Female ; Fibrin Fibrinogen Degradation Products - analysis ; HIV Infections - diagnosis ; HIV Infections - pathology ; HIV Seropositivity ; Human immunodeficiency virus ; Human immunodeficiency virus 1 ; Human viral diseases ; Humans ; Immunodeficiencies ; Immunodeficiencies. Immunoglobulinopathies ; Immunopathology ; Infectious diseases ; Interleukin-6 - blood ; Lentivirus ; Male ; Medical sciences ; Predictive Value of Tests ; Prognosis ; Randomized Controlled Trials as Topic ; Retroviridae ; Viral diseases ; Viral diseases of the lymphoid tissue and the blood. Aids
É parte de: AIDS (London), 2014-03, Vol.28 (6), p.869-874
Notas: ObjectType-Article-1
SourceType-Scholarly Journals-1
ObjectType-News-2
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Descrição: OBJECTIVE:Inflammation and coagulation biomarkers interleukin (IL)-6 and D-dimer are predictive of all-cause mortality in chronic HIV-1 infection; however, their predictive value in individuals with recent infection has not been described. METHODS:SPARTAC was a randomized controlled trial comparing three strategies of intervention in primary HIV-1 infection [no therapy, 12-week or 48-week antiretroviral therapy (ART)]. Plasma IL-6 and D-dimer were measured in 200 participants from sites in Australia, Brazil, UK and Italy. We evaluated age, sex/HIV risk group, time since HIV-1 seroconversion, baseline HIV-RNA, CD4 cell count and BMI as possible predictors of IL-6 and D-dimer levels at seroconversion using multivariable linear regression. For participants remaining ART-naive, we evaluated whether baseline IL-6 and D-dimer levels independently predicted time to reaching CD4 cell count less than 350 cells/μl or initiating ART using multivariable Cox proportional hazards models. RESULTS:Median (interquartile range, IQR) baseline IL-6 and D-dimer levels were 1.45 (0.88–2.41) pg/ml and 0.34 (0.20–0.50) μg/l, respectively. Higher levels were associated with older age (P = 0.008 and 0.004, respectively). Higher D-dimer levels were associated with higher HIV-RNA (P < 0.001). For the 73 participants not initiating ART (median follow-up 225 weeks), of whom 48 reached the primary endpoint, higher baseline IL-6, but not D-dimer, was independently associated with a shorter time to primary endpoint [hazard ratio = 1.38 per additional pg/ml, 95% confidence interval (CI) 1.09–1.75; P = 0.007]. Other baseline predictors were older age (P = 0.030), higher RNA (P = 0.033) and lower CD4 cell count (P < 0.001). CONCLUSION:IL-6 levels at time of HIV-1 seroconversion independently predict HIV-1 disease progression in patients with primary HIV-1 infection.
Editor: Hagerstown, MD: Lippincott Williams & Wilkins, Inc
Idioma: Inglês

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Interleukin-6 and D-dimer levels at seroconversion as predictors of HIV-1 disease progression

Hamlyn, Elizabeth ; Fidler, Sarah ; Stöhr, Wolfgang ; Cooper, David A ; Tambussi, Giuseppe ; Schechter, Mauro ; Miro, Jose M ; Mcclure, Myra ; Weber, Jonathan ; Babiker, Abdel ; Porter, Kholoud

Hagerstown, MD: Lippincott Williams & Wilkins, Inc

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