Biomarkers Associated with Death After Initiating Treatment for Tuberculosis and HIV in Patients with Very Low CD4 Cells
| Autor(a) principal: | |
|---|---|
| Data de Publicação: | 2018 |
| Outros Autores: | , , , , , , , , , |
| Tipo de documento: | Artigo |
| Idioma: | eng |
| Título da fonte: | Repositório Institucional da FIOCRUZ (ARCA) |
| Texto Completo: | https://www.arca.fiocruz.br/handle/icict/28909 |
Resumo: | 2019-09-18 |
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Sattler, Fred R.Chelliah, DanielWu, XingyeSanchez, AlejandroKendall, Michelle A.Hogg, EvelynLagat, DavidLalloo, UmeshVeloso, Valdiléa G.Havlir, Diane V.Landay, Alan2018-09-19T17:40:29Z2018-09-19T17:40:29Z2018SATTLER, Fred R. et al. Biomarkers Associated with Death After Initiating Treatment for Tuberculosis and HIV in Patients with Very Low CD4 Cells. Pathogens & immunity, v. 3, n. 1, p. 46–62, 2018.2469-2964https://www.arca.fiocruz.br/handle/icict/2890910.20411/pai.v3i1.235engBiomarkers Associated with Death After Initiating Treatment for Tuberculosis and HIV in Patients with Very Low CD4 Cellsinfo:eu-repo/semantics/publishedVersioninfo:eu-repo/semantics/article2019-09-18University of Southern California. Keck School of Medicine. Los Angeles, California, USA.University of Southern California. Keck School of Medicine. Los Angeles, California, USA.Harvard School of Public Health. Boston, Massachusetts, USA.University of Southern California. Keck School of Medicine. Los Angeles, California, USA.Harvard School of Public Health. Boston, Massachusetts, USA.Social & Scientific Systems Inc.. Silver Springs, Maryland, USA.Moi University Clinical Research Center. Eldoret, Kenya.Durban University of Technology. Enhancing Care Foundation. Durban, South Africa.Fundação Oswaldo Cruz. Instituto Nacional de Infectologia Evandro Chagas. Laboratório de Pesquisa Clínica em DST/AIDS. Rio de Janeiro, RJ, Brasil.University of California San Francisco. San Francisco, California, USA.Rush Presbyterian Medical Center. Chicago, Illinois, USA.Background: The risk of short-term death for treatment naive patients dually infected with Mycobacterium tuberculosis and HIV may be reduced by early anti-retroviral therapy. Of those dying, mechanisms responsible for fatal outcomes are unclear. We hypothesized that greater malnutrition and/or inflammation when initiating treatment are associated with an increased risk for death. Methods: We utilized a retrospective case-cohort design among participants of the ACTG A5221 study who had baseline CD4 < 50 cells/mm3. The case-cohort sample consisted of 51 randomly selected participants, whose stored plasma was tested for C-reactive protein, cytokines, chemokines, and nutritional markers. Cox proportional hazards models were used to assess the association of nutritional, inflammatory, and immunomodulatory markers for survival. Results: The case-cohort sample was similar to the 282 participants within the parent cohort with CD4 <50 cells/mm3. In the case cohort, 7 (14%) had BMI < 16.5 (kg/m2) and 17 (33%) had BMI 16.5-18.5(kg/m2). Risk of death was increased per 1 IQR width higher of log10 transformed level of C-reactive protein (adjusted hazard ratio (aHR) = 3.42 [95% CI = 1.33-8.80], P = 0.011), interferon gamma (aHR = 2.46 [CI = 1.02-5.90], P = 0.044), MCP-3 (3.67 [CI = 1.08-12.42], P = 0.037), and with IL-15 (aHR = 2.75 [CI = 1.08-6.98], P = 0.033) and IL-17 (aHR = 3.99 [CI = -1.06-15.07], P = 0.041). BMI, albumin, hemoglobin, and leptin levels were not associated with risk of death. Conclusions: Unlike patients only infected with M. tuberculosis for whom malnutrition and low BMI increase the risk of death, this relationship was not evident in our dually infected patients. Risk of death was associated with significant increases in markers of global inflammation along with soluble biomarkers of innate and adaptive immunity.Adaptive immunityHuman Immunodeficiency VirusInnate immunityMycobacterium tuberculosisNutrition biomarkersPredictors of mortalityTiming of antiretroviral therapyinfo:eu-repo/semantics/openAccessreponame:Repositório Institucional da FIOCRUZ (ARCA)instname:Fundação Oswaldo Cruz (FIOCRUZ)instacron:FIOCRUZLICENSElicense.txtlicense.txttext/plain; charset=utf-83099https://www.arca.fiocruz.br/bitstream/icict/28909/1/license.txt586c046dcfeef936e32f0323bb9a47c0MD51ORIGINALBiomarkers Associated with Death_Valdilea_Veloso_INI_Lapclin-AIDS_2018.pdfBiomarkers Associated with Death_Valdilea_Veloso_INI_Lapclin-AIDS_2018.pdfapplication/pdf410963https://www.arca.fiocruz.br/bitstream/icict/28909/2/Biomarkers%20Associated%20with%20Death_Valdilea_Veloso_INI_Lapclin-AIDS_2018.pdf7b91fabcab009abe76b2721910cd875dMD52TEXTBiomarkers Associated with 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| dc.title.pt_BR.fl_str_mv |
Biomarkers Associated with Death After Initiating Treatment for Tuberculosis and HIV in Patients with Very Low CD4 Cells |
| title |
Biomarkers Associated with Death After Initiating Treatment for Tuberculosis and HIV in Patients with Very Low CD4 Cells |
| spellingShingle |
Biomarkers Associated with Death After Initiating Treatment for Tuberculosis and HIV in Patients with Very Low CD4 Cells Sattler, Fred R. Adaptive immunity Human Immunodeficiency Virus Innate immunity Mycobacterium tuberculosis Nutrition biomarkers Predictors of mortality Timing of antiretroviral therapy |
| title_short |
Biomarkers Associated with Death After Initiating Treatment for Tuberculosis and HIV in Patients with Very Low CD4 Cells |
| title_full |
Biomarkers Associated with Death After Initiating Treatment for Tuberculosis and HIV in Patients with Very Low CD4 Cells |
| title_fullStr |
Biomarkers Associated with Death After Initiating Treatment for Tuberculosis and HIV in Patients with Very Low CD4 Cells |
| title_full_unstemmed |
Biomarkers Associated with Death After Initiating Treatment for Tuberculosis and HIV in Patients with Very Low CD4 Cells |
| title_sort |
Biomarkers Associated with Death After Initiating Treatment for Tuberculosis and HIV in Patients with Very Low CD4 Cells |
| author |
Sattler, Fred R. |
| author_facet |
Sattler, Fred R. Chelliah, Daniel Wu, Xingye Sanchez, Alejandro Kendall, Michelle A. Hogg, Evelyn Lagat, David Lalloo, Umesh Veloso, Valdiléa G. Havlir, Diane V. Landay, Alan |
| author_role |
author |
| author2 |
Chelliah, Daniel Wu, Xingye Sanchez, Alejandro Kendall, Michelle A. Hogg, Evelyn Lagat, David Lalloo, Umesh Veloso, Valdiléa G. Havlir, Diane V. Landay, Alan |
| author2_role |
author author author author author author author author author author |
| dc.contributor.author.fl_str_mv |
Sattler, Fred R. Chelliah, Daniel Wu, Xingye Sanchez, Alejandro Kendall, Michelle A. Hogg, Evelyn Lagat, David Lalloo, Umesh Veloso, Valdiléa G. Havlir, Diane V. Landay, Alan |
| dc.subject.en.pt_BR.fl_str_mv |
Adaptive immunity |
| topic |
Adaptive immunity Human Immunodeficiency Virus Innate immunity Mycobacterium tuberculosis Nutrition biomarkers Predictors of mortality Timing of antiretroviral therapy |
| dc.subject.en.none.fl_str_mv |
Human Immunodeficiency Virus Innate immunity Mycobacterium tuberculosis Nutrition biomarkers Predictors of mortality Timing of antiretroviral therapy |
| description |
2019-09-18 |
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2018 |
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2018-09-19T17:40:29Z |
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2018-09-19T17:40:29Z |
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2018 |
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info:eu-repo/semantics/publishedVersion |
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info:eu-repo/semantics/article |
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article |
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SATTLER, Fred R. et al. Biomarkers Associated with Death After Initiating Treatment for Tuberculosis and HIV in Patients with Very Low CD4 Cells. Pathogens & immunity, v. 3, n. 1, p. 46–62, 2018. |
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https://www.arca.fiocruz.br/handle/icict/28909 |
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2469-2964 |
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10.20411/pai.v3i1.235 |
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SATTLER, Fred R. et al. Biomarkers Associated with Death After Initiating Treatment for Tuberculosis and HIV in Patients with Very Low CD4 Cells. Pathogens & immunity, v. 3, n. 1, p. 46–62, 2018. 2469-2964 10.20411/pai.v3i1.235 |
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