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. Inflammation and mortality in HIV-infected adults: analysis of the FRAM study cohort.
Open accessAbstract
OBJECTIVE: To determine the association of inflammatory markers, fibrinogen, and C-reactive protein (CRP), with 5-year mortality risk. METHODS: Vital status was ascertained in 922 HIV-infected participants from the Study of Fat Redistribution and Metabolic Change in HIV infection. Multivariable logistic regression estimated odds ratios after adjustment for demographic, cardiovascular, and HIV-related factors. RESULTS: Over a 5-year period, HIV-infected participants with fibrinogen levels in the highest tertile (>406 mg/dL) had 2.6-fold higher adjusted odds of death than those with fibrinogen in the lowest tertile (<319 mg/dL). Those with high CRP (>3 mg/L) had 2.7-fold higher adjusted odds of death than those with CRP <1 mg/L. When stratified by CD4 count category, fibrinogen (as a linear variable) remained independently associated [odds ratio (95% confidence intervals)] per 100 mg/dL increase in fibrinogen: 1.93 (1.57 to 2.37); 1.43 (1.14 to 1.79); 1.43 (1.14 to 1.81); and 1.30 (1.04 to 1.63) for CD4 <200, 200-350, >350 to 500, and >500 cells per microliter, respectively. Higher CRP also remained associated with higher odds of death overall and within each CD4 subgroup. CONCLUSIONS: Fibrinogen and CRP are strong and independent predictors of mortality in HIV-infected adults. Our findings suggest that even in those with relatively preserved CD4 counts >500 cells per microliter, inflammation remains an important risk factor for mortality. Further investigation should determine whether interventions to reduce inflammation might decrease mortality risk in HIV-infected individuals.
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“The ability of these biomarkers to predict outcome has been observed in most patient populations, including those with preserved immune function (51).”
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 [51]
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Metadata
- Authors
- Tien, P. C., Choi, A. I., Zolopa, A. R., Benson, C., Tracy, R., Scherzer, R., Bacchetti, P., Shlipak, M., & Grunfeld, C.
- Affiliations
- San Francisco VA Medical Center (US)
- Stanford Medicine (US)
- University of California San Diego (US)
- University of California, San Francisco (US)
- Corresponding author
- Tien, Phyllis C
- Choi, Andy I
- Scherzer, Rebecca
- Shlipak, Michael
- ORCID
- Venue
- JAIDS Journal of Acquired Immune Deficiency Syndromes
- Published
- 2010-11-01
- Volume
- 55
- Issue
- 3
- Pages
- 316-322
- ISSN
- 1525-4135 (ISSN-L)
- PMC
- PMC2955817
- OpenAlex
- W2046166857
- Cited by
- 279
- References
- 28
- Citations by year
- 2026: 3 · 2025: 6 · 2024: 3 · 2023: 10 · 2022: 16 · 2021: 17 · 2020: 15 · 2019: 13 · 2018: 18 · 2017: 21 · 2016: 26 · 2015: 23 · 2014: 24 · 2013: 31 · 2012: 25
- FWCI
- 25.25
- Type
- journal article
- Language
- en
- Open access
- green
- www.ncbi.nlm.nih.gov
- Locations
- JAIDS Journal of Acquired Immune Deficiency Syndromes (publishedVersion)
- PubMed (publishedVersion)
- PubMed Central (acceptedVersion)
- Funders
- National Institutes of Health (2m01rr000083-41)
- National Heart, Lung, and Blood Institute (HL-53359, R01HL053359, HL-74814, R01HL074814)
- National Institute of Allergy and Infectious Diseases (K23AI066943)
- National Institute of Diabetes and Digestive and Kidney Diseases (DK080645, R01DK057508, K23DK080645)
- National Center for Research Resources (RR00054, UL1RR024131, RR-00051, RR 0636, M01RR000054, M01RR000051, RR 000 52, M01RR000052, M01-RR000083, RR00865, M01RR000865, RR 00083, M01RR000036)
- Topics
- Health Sciences › Medicine › Infectious Diseases › 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, inflammation, mortality, fibrinogen, C-reactive protein, inflammatory markers, CD4 count, mortality risk factors
- MeSH terms
- Adult, C-Reactive Protein, Female, Fibrinogen, Humans, Inflammation, Male, Middle Aged, Prognosis, HIV Infections, Survival Analysis, CD4 Lymphocyte Count
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