1. Immunologic Pathways That Predict Mortality in HIV-Infected Ugandans Initiating Antiretroviral Therapy.
- Author
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Lee, Sulggi, Byakwaga, Helen, Boum, Yap, Burdo, Tricia H., Williams, Kenneth C., Lederman, Michael M., Huang, Yong, Tracy, Russell P., Cao, Huyen, Haberer, Jessica E., Kembabazi, Annet, Bangsberg, David R., Martin, Jeffrey N., and Hunt, Peter W.
- Subjects
HIV ,IMMUNOLOGY ,ANTIRETROVIRAL agents ,INTERLEUKIN-6 ,IMMUNE response ,ANTI-HIV agents ,HIV infections ,UGANDANS ,INTERLEUKINS ,MULTIVARIATE analysis ,VIRAL load ,PROGNOSIS ,TRYPTOPHAN ,RESEARCH funding ,AMINO acids ,T cells ,FIBRIN fibrinogen degradation products ,LONGITUDINAL method ,ANTIGENS ,PROPORTIONAL hazards models - Abstract
The plasma kynurenine/tryptophan (KT) ratio, a marker of adaptive immune defects, strongly predicts mortality during treated human immunodeficiency virus (HIV) disease in Ugandans as compared to US-based populations. Here, the KT ratio and T-cell and plasma biomarkers of immune activation were measured among 535 HIV-infected Ugandans prior to ART initiation and at month 6 of viral suppression. The month 6 KT ratio (adjusted hazard ratio [aHR], 2.74), soluble CD14 level (aHR, 2.32), interleukin 6 level (aHR, 2.34), and D-dimer level (aHR, 1.95) were associated with mortality occurring ≥6 months after ART initiation. The KT ratio remained significantly predictive of mortality even after adjustment for the additional biomarkers, suggesting an independent contribution to clinical outcomes in resource-limited settings. [ABSTRACT FROM AUTHOR]
- Published
- 2017
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