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Interruption of antiretroviral therapy is associated with increased plasma cystatin C
- Source :
- University of Helsinki, Mocroft, A, Wyatt, C, Szczech, L, Neuhaus, J, El-Sadr, W, Tracy, R, Kuller, L, Shlipak, M, Angus, B, Klinker, H, Ross, M, INSIGHT SMART Study Group, Østergaard, L J & Nielsen, H I 2009, ' Interruption of antiretroviral therapy is associated with increased plasma cystatin C ', AIDS, vol. 23, no. 1, pp. 71-82 . https://doi.org/10.1097/QAD.0b013e32831cc129
- Publication Year :
- 2009
- Publisher :
- Ovid Technologies (Wolters Kluwer Health), 2009.
-
Abstract
- Udgivelsesdato: 2009-Jan-2 BACKGROUND: Cystatin C has been proposed as an alternative marker of renal function. We sought to determine whether participants randomized to episodic use of antiretroviral therapy guided by CD4 cell count (drug conservation) had altered cystatin C levels compared with those randomized to continuous antiretroviral therapy (viral suppression) in the Strategies for Management of Antiretroviral Therapy trial, and to identify factors associated with increased cystatin C. METHODS: Cystatin C was measured in plasma collected at randomization, 1, 2, 4, 8 and 12 months after randomization in a random sample of 249 and 250 participants in the drug conservation and viral suppression groups, respectively. Logistic regression was used to model the odds of at least 0.15 mg/dl increase in cystatin C (1 SD) in the first month after randomization, adjusting for demographic and clinical characteristics. RESULTS: At randomization, mean (SD) cystatin C level was 0.99 (0.26 mg/dl) and 1.01 (0.28 mg/dl) in the drug conservation and viral suppression arms, respectively (P = 0.29). In the first month after randomization, 21.8 and 10.6% had at least 0.15 mg/dl increase in cystatin C in the drug conservation and viral suppression arms, respectively (P = 0.0008). The difference in cystatin C between the treatment arms was maintained through 1 year after randomization. After adjustment, participants in the viral suppression arm had significantly reduced odds of at least 0.15 mg/dl increase in cystatin C in the first month (odds ratio 0.42; 95% confidence interval 0.23-0.74, P = 0.0023). CONCLUSION: These results demonstrate that interruption of antiretroviral therapy is associated with an increase in cystatin C, which may reflect worsened renal function.
- Subjects :
- Adult
Male
medicine.medical_specialty
Randomization
Anti-HIV Agents
Immunology
Renal function
HIV Infections
Kidney
urologic and male genital diseases
Gastroenterology
Article
Drug Administration Schedule
law.invention
Randomized controlled trial
law
Antiretroviral Therapy, Highly Active
Internal medicine
medicine
Humans
Immunology and Allergy
Cystatin C
biology
business.industry
Odds ratio
Middle Aged
Viral Load
Lipids
Confidence interval
CD4 Lymphocyte Count
Infectious Diseases
biology.protein
Biological Markers
Female
Cystatin
business
Viral load
Biomarkers
Glomerular Filtration Rate
Subjects
Details
- ISSN :
- 02699370
- Volume :
- 23
- Database :
- OpenAIRE
- Journal :
- AIDS
- Accession number :
- edsair.doi.dedup.....7752ffd5586363c7b8ee9f3acf781848