Associations between baseline biomarkers and lung function in HIV-positive individuals

• Published in: AIDS (London) Vol. 33; no. 4; pp. 655 - 664
• Main Authors: MacDonald, David M, Zanotto, Alexander D, Collins, Gary, Baker, Jason V, Czarnecki, Marcin, Loiza, Eliana, Nixon, Daniel E, Papastamopoulos, Vasileios, Wendt, Chris H, Wood, Robin, Kunisaki, Ken M
• Format: Journal Article
• Language: English
• Published: England Copyright Wolters Kluwer Health, Inc 15.03.2019
• Subjects: Adult; AIDS/HIV; Biomarkers - analysis; Disease Progression; Female; HIV Infections - complications; HIV Infections - pathology; Humans; Longitudinal Studies; Lung - physiology; Lung Diseases - pathology; Male; Respiratory Function Tests
• ISSN: 0269-9370; 1473-5571
• DOI: 10.1097/QAD.0000000000002101

OBJECTIVE:The aim of this study was to analyse the association of baseline biomarker data with cross-sectional lung function and subsequent decline in lung function in HIV-positive persons. DESIGN:Lung function was modelled in all START pulmonary substudy participants who had baseline biomarker data and good-quality spirometry. In longitudinal analyses, we restricted to those participants with at least one good-quality follow-up spirometry test. METHODS:We performed linear regression of baseline forced expiratory volume in 1 s (FEV1), forced vital capacity (FVC) and FEV1/FVC and their longitudinal slopes on log2-transformed baseline biomarkers with adjustment for age, sex, race, region, smoking status, baseline CD4 T-cell counts and baseline HIV-RNA. Biomarkers included D-dimer, high-sensitivity C-reactive protein (hsCRP), interleukin (IL)-6, IL-27, serum amyloid A, soluble intercellular adhesion molecule (sICAM)-1, soluble vascular cell adhesion molecule (sVCAM)-1, albumin and total bilirubin. RESULTS:Among 903 included participants, baseline median age was 36 years, CD4 cell count was 647 cells/μl, and 28.5% were current smokers. In adjusted analyses, elevated markers of systemic inflammation (hsCRP, IL-6 and serum amyloid A) were associated with lower baseline FEV1 and FVC. Elevated D-dimer and IL-6 were associated with worse airflow obstruction (lower FEV1/FVC). Despite these cross-sectional associations at baseline, no associations were found between baseline biomarkers and subsequent longitudinal lung function decline over a median follow-up time of 3.9 years (3293 spirometry-years of follow-up). CONCLUSION:Commonly available biomarkers, in particular markers of systemic inflammation, are associated with worse cross-sectional lung function, but do not associate with subsequent lung function decline among HIV-positive persons with early HIV infection and baseline CD4 T-cell counts more than 500 cells/μl.