Effect of Universal Testing and Treatment on HIV Incidence - HPTN 071 (PopART)
Neural-Tube Defects and Antiretroviral Treatment Regimens in Botswana
Virological remission after antiretroviral therapy interruption in female African HIV seroconverters
Do people living with HIV experience greater age advancement than their HIV-negative counterparts?
Prednisone for the Prevention of Paradoxical Tuberculosis-Associated IRIS
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Kidney Diseases Associated with Human Immunodeficiency Virus Infection
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CD32a is a marker of a CD4 T-cell HIV reservoir harbouring replication-competent proviruses
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Successful Prevention of Transmission of Integrase Resistance in the Swiss HIV Cohort Study
Immunologic Biomarkers, Morbidity, and Mortality in Treated HIV Infection
Rosuvastatin slows progression of subclinical atherosclerosis in patients with treated HIV infection
Antiretroviral therapy for the prevention of HIV-1 transmission
HIV Transmission Risk Persists During the First 6 Months of Antiretroviral Therapy
Review of the Efficacy, Safety, and Pharmacokinetics of Raltegravir in Pregnancy
Use of Abacavir and Risk of Cardiovascular Disease Among HIV-Infected Individuals
Patterns of Cardiovascular Mortality for HIV-Infected Adults in the United States: 1999 to 2013
Adjunctive Dexamethasone in HIV-Associated Cryptococcal Meningitis
Outcomes of HIV-associated Hodgkin lymphoma in the era of antiretroviral therapy
CD8 T-Cell Expansion and Inflammation Linked to CMV Coinfection in ART-treated HIV Infection
Ongoing HIV Replication Replenishes Viral Reservoirs During Therapy
Incidence and progression of coronary artery calcium in HIV-infected and HIV-uninfected men
Levels of intracellular HIV-DNA in patients with suppressive antiretroviral therapy
Course and Clinical Significance of CD8+ T-Cell Counts in a Large Cohort of HIV-Infected Individuals
Impact of low-level viremia on clinical and virological outcomes in treated HIV-1-infected patients
Predicting the outcomes of treatment to eradicate the latent reservoir for HIV-1
Association of immune-activation and senescence markers with non-AIDS-defining comorbidities in HIV-suppressed patients
Published by François RAFFI
Updated: 15 December, 2015
This study assessed the link between T-cell activation, differentiation and senescence phenotypes and non-AIDS-related comorbidities in HIV-suppressed patients. Patients included in the ANRS CO3 Aquitaine Cohort were consecutively enrolled in this cross-sectional study between October 2011 and May 2013 called Chronic Immune Activation and Senescence (CIADIS) study. Immune [CD4+ and CD8+ activation (DR+), differentiation (naïve and terminally differentiated memory T cells), and senescence (CD57+CD28-)] markers were summarized in a weighted immune score by principal component analysis called CIADIS. Previously described Veterans Aging Cohort Study (VACS) index and immune risk profile (IRP) scores were calculated. Adjusted logistic regression was used to assess the association between the CIADIS score and the presence of at least three non-AIDS-defining comorbidities. Only patients with plasma HIV-RNA below 40 copies/ml were analyzed. The number of comorbidities present for each patient were counted (comorbidity score) among: eGFR below 60 ml/min, diabetes, dyslipidemia, cardiovascular events, hypertension, degenerative CNS disorders, and cancer. The main outcome variable was a high comorbidity score, defined as at least 3 comorbidities.
Of 876 patients with an undetectable viral load, 73.4% were men and median age was 50.5 years [interquartile range (IQR) 44.7–56.7 years]. Median CD4 T-cell count was 579/ml (IQR 429–759 cells/ml), and median duration of HIV viral suppression was of 5.3 years (IQR 2.3–8.7). The weighted CIADIS score was associated with at least 3 comorbidities (odds ratio 1.3, 95% confidence interval 1.0, 1.6) independently of age, sex, AIDS stage, and the Veterans Aging Cohort Study score. The CIADIS and the immune risk profile scores were significantly associated with at least 3 comorbidities in adjusted models restricted to patients younger than 60 years. None of the tested scores were associated with at least three comorbidities in patients older than 60 years.
In a large assessment of cellular activation markers in patients under routine care, a significant association was found between the CIADIS score and a high comorbidity score, whereas the VACS index score as well as the IRP score were not associated with a high comorbidity score in multivariable analysis.
In conclusion, the weighted CIADIS score based on activation, senescence, and maturation markers might help physicians identifying patients at a higher risk for non-AIDS-related comorbidities.