Markers of Inflammation, Coagulation, and Renal Function Are Elevated in Adults with HIV Infection
Open accessAbstract
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.
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HAART does not protect patients from persistent immune activation, chronic inflammation, and excess risk of developing CVD and frailty.
“However, this therapy does not protect patients from the persistent immune activation, chronic inflammation, and excess risk of developing CVD and frailty131–135.”
From Inflammageing: chronic inflammation in ageing, cardiovascular disease, and frailty (2018) · cites this paper as [132]
Many, but not all, biomarkers associated with inflammation (e.g., IL-6, sCD14) and end-organ diseases common in seniors (e.g., cystatin C as a marker of declining renal function) are higher in antiretroviral-treated adults than uninfected adults.
“Many (but not all) biomarkers associated with inflammation (e.g., IL-6, sCD14) and end-organ diseases common in seniors (e.g., cystatin C as a marker of declining renal function) are higher in antiretroviral-treated adults than uninfected adults (50).”
From HIV and Aging: State of Knowledge and Areas of Critical Need for Research. A Report to the NIH Office of AIDS Research by the HIV and Aging Working Group (2012) · cites this paper as [50]
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- Authors
- Neuhaus, J., Jacobs, Jr., Baker, J. V., Calmy, A., Duprez, D., La Rosa, A., Kuller, L. H., Pett, S. L., Ristola, M., Ross, M. J., Shlipak, M. G., Tracy, R., & Neaton, J. D.
- Affiliations
- University of Minnesota (US)
- University of Geneva (CH)
- University of Pittsburgh (US)
- UNSW Sydney (AU)
- University of Helsinki (FI)
- Icahn School of Medicine at Mount Sinai (US)
- University of California, San Francisco (US)
- University of Vermont (US)
- Corresponding author
- Neuhaus, Jacqueline
- ORCID
- Venue
- The Journal of Infectious Diseases
- Publisher
- Oxford University Press (OUP)
- Published
- 2010-06-15
- Volume
- 201
- Issue
- 12
- Pages
- 1788-1795
- ISSN
- 0022-1899 (ISSN-L)
- 1537-6613
- PMC
- PMC2872049
- OpenAlex
- W2127517680
- Cited by
- 869
- References
- 33
- Citations by year
- 2026: 29 · 2025: 25 · 2024: 30 · 2023: 50 · 2022: 59 · 2021: 49 · 2020: 60 · 2019: 54 · 2018: 53 · 2017: 66 · 2016: 58 · 2015: 65 · 2014: 68 · 2013: 67 · 2012: 69
- FWCI
- 61.22
- Type
- journal article
- Language
- en
- Open access
- bronze
- doi.org
- Locations
- The Journal of Infectious Diseases (publishedVersion)
- PubMed (publishedVersion)
- Europe PMC (PubMed Central) (acceptedVersion)
- PubMed Central (acceptedVersion)
- Archive ouverte UNIGE (University of Geneva) (acceptedVersion, other-oa)
- reroDoc Digital Library (submittedVersion)
- UCL Discovery (University College London) (submittedVersion)
- Archive ouverte UNIGE (University of Geneva) (submittedVersion, cc-by)
- Funders
- National Institutes of Health (n01hc95095-66-0-1, n01hc95164-17-0-1, n01hc48050-59-0-1, n01hc48048-58-0-1, n01hc95165-34-0-1, n01hc48047-55-0-1, n01hc95161-24-0-1, n01hc095169-003, n01hc95166-21-0-1, n01hc48049-61-0-1, n01hc95162-31-0-1, n01hc95168-27-0-1, n01hc95160-18-0-1, n01hc095167-000, N01-HC- 95159, n01hc95163-22-0-1, n01hc95159-40-0-1, N01‐HC‐95169)
- National Heart, Lung, and Blood Institute (N01HC48050, N01 HC-95159, N01-HC095169, N01-HC-095165, N01 HC 95095, N01 HC095163, N01 HC048048, N01-HC-048049, N01-HC-095159, N01 HC095168, NO1-HC-48049, N01-HC-095162, N01 HC095095, N01-HC-095161, N01 HC048050, N01-HC48048, N01 HC095167, N01-HC-48-049, N01-HC-095160, N01 HC095166, N01 HC095164, N01 HC048047, NO1-HC-95095, N01-HC-480-47, N01 HC95169)
- National Institute of Allergy and Infectious Diseases (U01 AI46362, U01AI046362, U01AI042170)
- National Institute of Diabetes and Digestive and Kidney Diseases (R01DK078510)
- Topics
- Health Sciences › Medicine › Emergency Medicine › HIV-related health complications and treatments
- Life Sciences › Immunology and Microbiology › Virology › HIV Research and Treatment
- Health Sciences › Medicine › Infectious Diseases › HIV/AIDS Research and Interventions
- Keywords
- HIV infection, inflammatory markers, coagulation markers, renal function, high-sensitivity C-reactive protein, interleukin-6, D-dimer, cystatin C, antiretroviral therapy, viral suppression, immune activation, cardiovascular risk
- MeSH terms
- Adult, Aged, Blood Coagulation Disorders, C-Reactive Protein, Female, Fibrin Fibrinogen Degradation Products, Humans, Inflammation, Kidney Diseases, Male, Middle Aged, Biomarkers, HIV Infections, Interleukin-6, Anti-HIV Agents, Viral Load, Cystatin C
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