Markers of inflammation, coagulation, and renal function are elevated in adults with HIV infection

Abstract

Background: Human immunodeficiency virus (HIV) replication and immune activation may increase inflammation and coagulation biomarkers. Limited data exist comparing such biomarkers in persons with and without HIV infection.

Methods: For persons 45-76 years of age, levels of high-sensitivity C-reactive protein (hsCRP), interleukin (IL)-6, D-dimer, and cystatin C were compared in 494 HIV-infected individuals in the Strategies for Management of Anti-Retroviral Therapy (SMART) study and 5386 participants in the Multi-Ethnic Study of Atherosclerosis (MESA) study. For persons 33-44 years of age, hsCRP and IL-6 levels were compared in 287 participants in the SMART study and 3231 participants in the Coronary Artery Development in Young Adults (CARDIA) study.

Results: hsCRP and IL-6 levels were 55% (P < . 001) and 62 (P < . 001) higher among HIV-infected participants than among CARDIA study participants. Compared with levels noted in MESA study participants, hsCRP, IL-6, D-dimer, and cystatin C levels were 50%, 152%, 94%, and 27% higher, respectively (P < . 001, for each), among HIV-infected participants. HIV-infected participants receiving antiretroviral therapy who had HIV RNA levels 400 copies/mL had levels higher (by 21% to 60%) (P < . 001) than those in the general population, for all biomarkers.

Conclusions: hsCRP, IL-6, D-dimer, and cystatin C levels are elevated in persons with HIV infection and remain so even after HIV RNA levels are suppressed with antiretroviral therapy. Additional research is needed on the pathophysiology of HIV-induced activation of inflammatory and coagulation pathways, to guide potential interventions.

Conflict of interest statement

Russell Tracy reports being a paid Consultant to Abbott and Merck. No other authors have a commercial or other association that might pose a conflict of interest.

Figures

Figure 1

Figure 1a: Percentage Difference (HIV-infected versus General Population for hsCRP and IL-6): Participants Aged 33–44 Years. Figure 1b: Percentage Difference (HIV-infected versus General Population for hsCRP, IL-6, D-dimer and Cystatin C): Participants Aged 45–76 Years.

Figure 1

Figure 1a: Percentage Difference (HIV-infected versus General Population for hsCRP and IL-6): Participants Aged 33–44 Years. Figure 1b: Percentage Difference (HIV-infected versus General Population for hsCRP, IL-6, D-dimer and Cystatin C): Participants Aged 45–76 Years.