Inflammation and micronutrient biomarkers predict clinical HIV treatment failure and incident active TB in HIV-infected adults: a case-control study

炎症和微量营养素生物标志物可预测 HIV 感染成人临床 HIV 治疗失败和活动性结核病发病率:一项病例对照研究

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作者:Rupak Shivakoti, Nikhil Gupte, Srikanth Tripathy, Selvamuthu Poongulali, Cecilia Kanyama, Sima Berendes, Sandra W Cardoso, Breno R Santos, Alberto La Rosa, Noluthando Mwelase, Sandy Pillay, Wadzanai Samaneka, Cynthia Riviere, Patcharaphan Sugandhavesa, Robert C Bollinger, Ashwin Balagopal, Richard D

Background

Various individual biomarkers of inflammation and micronutrient status, often correlated with each other, are associated with adverse treatment outcomes in human immunodeficiency virus (HIV)-infected adults. The

Conclusion

Factors identified through EFA were associated with adverse outcomes in HIV-infected individuals. Strategies focused on reducing adverse HIV outcomes through therapeutic interventions that target the underlying factor (e.g., inflammation) rather than focusing on an individual observed biomarker might be more effective and warrant further investigation.

Methods

Within a multicountry randomized trial of antiretroviral therapy (ART) efficacy (PEARLS) among HIV-infected adults, we nested a case-control study (n = 290; 124 cases, 166 controls) to identify underlying factors, based on EFA of 23 baseline (pre-ART) biomarkers of inflammation and micronutrient status. The EFA biomarker groupings

Results

In the primary analysis, based on eigenvalues> 1 in the EFA, three factors were extracted: (1) carotenoids), (2) other nutrients, and (3) inflammation. In multivariable-adjusted models, there was an increased hazard of CTF (adjusted hazard ratio (aHR) 1.47, 95% confidence interval (CI)1.17-1.84) per unit increase of inflammation factor score. In the secondary incident active TB case-control analysis, higher scores of the high carotenoids and low interleukin-18 factor was protective against incident active TB (aHR 0.48, 95% CI 0.26-0.87).

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