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Clinical characteristics of HIV-1-infected patients with high levels of plasma interferon-?: a multicenter observational study.

ABSTRACT: BACKGROUND:Circulating interferon-? (IFN-?) concentration may be sustained at a high level regardless of the initiation of antiretroviral therapy (ART) in some patients with HIV-1 infection. In the present study, we examined the clinical characteristics of HIV-1-infected patients with high levels of plasma IFN-?. METHODS:The study subjects were patients infected with HIV-1 who were either naïve to ART with CD4+ cell count >?200 cells/?L (n?=?12), or had achieved viral suppression after ART for over a year (n?=?188). The levels of plasma IFN-? and interleukin-6 (IL-6) were measured by the enzyme-linked immunosorbent assay. Patients were divided into high IFN-? and low IFN-? groups based on a cutoff level of 5?pg/mL. RESULTS:The high IFN-? group included 41 patients (21%). Compared to the patients on ART with low IFN-? levels, those on ART in the high IFN-? group were more likely to be younger than 50?years of age (P?=?0.0051) and less likely to have dyslipidemia (P?=?0.0476) or to be on a protease inhibitor (P?=?0.0449). There was no significant difference between groups in the median increase of CD4+ cell counts from the initiation of ART for up to 3?years. However, after 4?years, the increase in CD4+ cell counts was significantly lower in the high IFN-? group compared with that in the low IFN-? group. There were no such significant differences between patients with low and high (>?2?pg/mL) levels of plasma IL-6. CONCLUSION:We concluded that HIV-1-infected patients with high levels of circulating IFN-? did not have a higher rate of comorbidities related to immune activation. However, they exhibited lower CD4+ cell count recovery after 4?years of being on ART. This deficit could be a consequence of persistent immune activation.

SUBMITTER: Watanabe D

PROVIDER: S-EPMC6321664 | biostudies-literature | 2019 Jan

REPOSITORIES: biostudies-literature

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Clinical characteristics of HIV-1-infected patients with high levels of plasma interferon-γ: a multicenter observational study.

Watanabe Dai D Uehira Tomoko T Suzuki Sachiko S Matsumoto Erina E Ueji Takashi T Hirota Kazuyuki K Minami Rumi R Takahama Soichiro S Hayashi Kimikazu K Sawamura Morio M Yamamoto Masahiro M Shirasaka Takuma T

BMC infectious diseases 20190105 1

<h4>Background</h4>Circulating interferon-γ (IFN-γ) concentration may be sustained at a high level regardless of the initiation of antiretroviral therapy (ART) in some patients with HIV-1 infection. In the present study, we examined the clinical characteristics of HIV-1-infected patients with high levels of plasma IFN-γ.<h4>Methods</h4>The study subjects were patients infected with HIV-1 who were either naïve to ART with CD4<sup>+</sup> cell count > 200 cells/μL (n = 12), or had achieved viral s ...[more]

PMID: 30611204

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Project description:National guidelines recommend screening for latent tuberculosis infection (LTBI) in all HIV-infected patients. Thus, the objective of this study was to measure protocol adherence to national guidelines regarding LTBI screening for HIV-infected patients entering care at an urban primary care clinic specializing in HIV care, identify clinical and other characteristics associated with adherence, and determine whether transitioning from the tuberculin skin test (TST) to the interferon-gamma release assay (IGRA) improved adherence. We conducted a retrospective study using protocol adherence to LTBI screening guidelines within twelve months of entering care at an HIV clinic as the primary outcome. Successful protocol adherence was defined as the placement and reading of a TST, performance of an IGRA, or a note in study clinic records documenting prior testing or treatment for tuberculosis in an outside setting. Multivariable modified Poisson regression models were used in analyses. Overall, 32% (n?=?118/372) of patients received LTBI screening within twelve months of entering care. Protocol adherence to LTBI screening guidelines increased from 28% to 37% following the transition from TST to IGRA screening. IGRA screening [adjusted prevalence ratio: 1.45, 95% confidence limits: (1.07, 1.96)], male sex [1.47 (1.05, 2.07)], transfer patient status [1.51 (1.05, 2.18)], and greater than one year of clinic attendance [1.62 (1.06, 2.48)] were independently associated with protocol adherence. Among patients without prior LTBI screening or treatment, patients entering the clinic in 2013 under the IGRA screening protocol were more likely to be screened for LTBI compared to patients entering under the TST screening protocol (34.3% vs. 9.7%, p?<?0.001). In conclusion, transitioning from TST to IGRA-based screening improved adherence to screening guidelines. However, further work on improving adherence to LTBI screening guidelines among HIV-infected patients is needed.

Project description:Abstract Background Both antiretroviral therapy (ART) and polymorphism in genes involved in lipoprotein metabolism contribute to the development of ART-induced dyslipidemia. Apolipoprotein A5 (APOA5)gene variant, which vary by race/ethnicity, influence plasma lipid concentrations. We explored the association of candidate gene effect on plasma lipid levels with food in HIV-infected children initiating ART in south India. Methods HIV-infected children, between 2 and 12 years of age initiating non-nucleoside reverse transcriptase inhibitor (NNRTI)-based ART during 2010–2014 were included. They were assessed for their dietary intake by 24-hour dietary recall. Fasting blood was drawn for serum triglycerides (TGL), total cholesterol and high-density cholesterol along with CD4 cell count, and HIV-1 viral load. APOA5 gene polymorphisms rs662799, rs3135506 were determined by Taqman single-nucleotide polymorphism (SNP) genotyping assays. The General Linear Model (GLM) was applied to explore the risk of hypertriglyceridemia for SNP’s rs662799 and rs3135506 with food interaction in children. Results Three hundred and ninety HIV-infected children {median age (IQR): 9 (5–11) years; and median viral load: 141,000 (25,876–436,000) copies/mL} were started on NNRTI-based ART. The frequency of c allele was 20% and 3.0% in rs662799, rs3135506, respectively. The GLM model suggested that the SNP rs662799 has significant association with TGL(P < 0.01); there was, however no interaction between gene polymorphisms and food. Also, the prediction model revealed that those who had a carrier allele (C) had higher TGL level as compared with those with wild type (165 vs. 138 mg/dL) and girls had higher TGL levels compared with boys. Conclusion Children with carrier allele of APOA5 are prone to hypertriglyceridemia, irrespective of diet or drugs. These children require periodic monitoring of lipid parameters and effective interventions to prevent the development of atherogenic or metabolic complications. Disclosures All authors: No reported disclosures.

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Clinical characteristics of HIV-1-infected patients with high levels of plasma interferon-?: a multicenter observational study.

Publications

Clinical characteristics of HIV-1-infected patients with high levels of plasma interferon-γ: a multicenter observational study.

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