Markers of inflammation, coagulation, and renal function are elevated in adults with HIV infection

J Infect Dis. 2010 Jun 15;201(12):1788-95. doi: 10.1086/652749.

Abstract

Background: Human immunodeficiency virus (HIV) replication and immune activation may increase inflammation and coagulation biomarkers. Limited data exist comparing such biomarkers in persons with and without HIV infection.

Methods: For persons 45-76 years of age, levels of high-sensitivity C-reactive protein (hsCRP), interleukin (IL)-6, D-dimer, and cystatin C were compared in 494 HIV-infected individuals in the Strategies for Management of Anti-Retroviral Therapy (SMART) study and 5386 participants in the Multi-Ethnic Study of Atherosclerosis (MESA) study. For persons 33-44 years of age, hsCRP and IL-6 levels were compared in 287 participants in the SMART study and 3231 participants in the Coronary Artery Development in Young Adults (CARDIA) study.

Results: hsCRP and IL-6 levels were 55% (P < . 001) and 62 (P < . 001) higher among HIV-infected participants than among CARDIA study participants. Compared with levels noted in MESA study participants, hsCRP, IL-6, D-dimer, and cystatin C levels were 50%, 152%, 94%, and 27% higher, respectively (P < . 001, for each), among HIV-infected participants. HIV-infected participants receiving antiretroviral therapy who had HIV RNA levels 400 copies/mL had levels higher (by 21% to 60%) (P < . 001) than those in the general population, for all biomarkers.

Conclusions: hsCRP, IL-6, D-dimer, and cystatin C levels are elevated in persons with HIV infection and remain so even after HIV RNA levels are suppressed with antiretroviral therapy. Additional research is needed on the pathophysiology of HIV-induced activation of inflammatory and coagulation pathways, to guide potential interventions.

Publication types

  • Research Support, N.I.H., Extramural

MeSH terms

  • Adult
  • Aged
  • Anti-HIV Agents / therapeutic use
  • Biomarkers
  • Blood Coagulation Disorders / pathology*
  • C-Reactive Protein / analysis
  • Cystatin C / blood
  • Female
  • Fibrin Fibrinogen Degradation Products / analysis
  • HIV Infections / complications*
  • HIV Infections / drug therapy
  • Humans
  • Inflammation / pathology*
  • Interleukin-6 / blood
  • Kidney Diseases / pathology*
  • Male
  • Middle Aged
  • Viral Load

Substances

  • Anti-HIV Agents
  • Biomarkers
  • Cystatin C
  • Fibrin Fibrinogen Degradation Products
  • Interleukin-6
  • fibrin fragment D
  • C-Reactive Protein

Grant support