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Inflammatory biomarkers and abacavir use in the Women's Interagency HIV Study and the Multicenter AIDS Cohort Study

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Palella, Frank J, Gange, Stephen J, Benning, Lorie, Jacobson, Lisa, Kaplan, Robert C, Landay, Alan L, Tracy, Russell P, Elion, Richard·2010·AIDS

Abstract

OBJECTIVE: To assess associations between abacavir (ABC) use and systemic inflammation. DESIGN: Nested case-control study. METHODS: The Multicenter AIDS Cohort Study (MACS) and Women's Interagency HIV Study (WIHS) cohort participants who initiated ABC were matched, using propensity score methods, to ABC-unexposed persons. Levels of high-sensitivity C-reactive protein (hsCRP) (microg/ml), interleukin-6 (IL-6) (pg/ml), and D-dimer (microg/ml) were measured from pre-HAART and on-HAART plasma. Random-effects models compared markers by ABC exposure and by changes from pre-HAART levels. RESULTS: Biomarkers were measured in N = 508 matched pairs (328 women; 180 men). Pre-HAART levels did not differ by exposure group except that hsCRP levels were higher among WIHS women who subsequently used ABC (P = 0.04). Regardless of ABC use, mean hsCRP increases and D-dimer reductions were seen when comparing pre-HAART to on-HAART levels, in the overall group (28 and -27%), for MACS men (28 and -31%) and for WIHS women [29 and -24%, P < 0.01 for all]; IL-6 levels declined in MACS men (P = 0.02). No adjusted biomarker level differences existed by ABC exposure at the on-HAART visit. HIV RNA reductions correlated with D-dimer (r = 0.14, P < 0.01) and IL-6 (r = 0.12, P < 0.01) reductions. Associations between ABC use and mean biomarker levels were modified by pre-HAART antiretroviral therapy experience. Renal dysfunction was equally likely among non-ABC and ABC recipients. DISCUSSION: ABC use was not associated with plasma elevations in hsCRP, IL-6, and D-dimer. Mechanisms other than increased systemic inflammation may account for ABC's reported association with increased cardiovascular disease. HAART-associated reductions in D-dimer and IL-6 were apparent regardless of ABC use and were correlated with HIV RNA reductions.

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Authors
Palella, F. J., Gange, S. J., Benning, L., Jacobson, L., Kaplan, R. C., Landay, A. L., Tracy, R. P., & Elion, R.
Affiliations
  • Northwestern University (US)
  • Johns Hopkins University (US)
  • Albert Einstein College of Medicine (US)
  • Rush University Medical Center (US)
  • University of Vermont (US)
  • George Washington University (US)
Corresponding author
Palella, Frank J
Venue
AIDS
Published
2010-07-17
Volume
24
Issue
11
Pages
1657-1665
ISSN
0269-9370 (ISSN-L)
OpenAlex
W1979036222
Cited by
61
References
21
Citations by year
2022: 3 · 2020: 3 · 2018: 4 · 2017: 5 · 2016: 5 · 2015: 9 · 2014: 4 · 2013: 8 · 2012: 10
FWCI
3.15
Type
journal article
Language
en
Open access
Locations
  • AIDS (publishedVersion)
  • PubMed (publishedVersion)
  • PubMed Central (acceptedVersion)
Funders
  • National Institute of Allergy and Infectious Diseases
  • National Center for Research Resources (M01RR000048)
Topics
  • Life Sciences › Immunology and Microbiology › Virology › HIV Research and Treatment
  • Health Sciences › Medicine › Emergency Medicine › HIV-related health complications and treatments
  • Health Sciences › Medicine › Infectious Diseases › HIV/AIDS drug development and treatment
Keywords
abacavir, systemic inflammation, C-reactive protein, interleukin-6, D-dimer, HIV infection, antiretroviral therapy, highly active antiretroviral therapy, cardiovascular risk, renal dysfunction, HIV RNA suppression, Women's Interagency HIV Study, Multicenter AIDS Cohort Study
MeSH terms
Abacavir, Adult, C-Reactive Protein, Female, Fibrin Fibrinogen Degradation Products, Humans, Inflammation, Male, Middle Aged, RNA, Viral, Dideoxynucleosides, Biomarkers, HIV-1, HIV Infections, Interleukin-6, Case-Control Studies, Inflammation Mediators, Reverse Transcriptase Inhibitors, Anti-HIV Agents, Antiretroviral Therapy, Highly Active

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