Associations between baseline biomarkers and lung function in HIV-positive individuals
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...
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Published in | AIDS (London) Vol. 33; no. 4; pp. 655 - 664 |
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Main Authors | , , , , , , , , , , |
Format | Journal Article |
Language | English |
Published |
England
Copyright Wolters Kluwer Health, Inc
15.03.2019
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Subjects | |
Online Access | Get full text |
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Summary: | 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. |
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Bibliography: | ObjectType-Article-1 SourceType-Scholarly Journals-1 ObjectType-Feature-2 content type line 23 Acquired the data: JVB, MC, EL, VP, DEN, RW, and KMK Designed the study: ADZ, GC, JVB and KMK Performed the primary statistical analyses: GC See START pulmonary substudy (supplemental appendix section) for a complete listing of START Pulmonary Substudy investigators[27] and the START trial (supplemental appendix section) for a complete listing of START trial investigators.[25] Critically revised the manuscript for important intellectual content and approved the final manuscript: DMM, ADZ, GC, JVB, MC, EL, DEN, VP, CHW, RW, KMK Obtained funding: KMK Conceived the study: ADZ and KMK Drafted the manuscript: DMM and AZ Take responsibility for the integrity of the data and the accuracy of the data analysis: DMM, ADZ, GC, KMK D.M. MacDonald and A.D. Zanotto shared co-primary author responsibilities. Author contributions |
ISSN: | 0269-9370 1473-5571 |
DOI: | 10.1097/QAD.0000000000002101 |